Test result changes...

[Sirenet]

Hi. I had an extremely strange experience yesterday during a cardiac dr visit. Anyone familar with my condition, I apologize in advance for it's repetitiveness, but feel a full explanation needed for complete understanding.
  I was made aware of my heart condition back in Dec when I went to ER with a bad gall bladder. The blood tests showed my BNP to be 1072 (extreme heart failure range) and my EKG was terrible. I was TOTALLY ignorant of what any of this meant back then, but have since learned. ER dr, while sonogram showed that my gall bladder had to be taken out, said never mind that, look at that heart. So, all the typical tests were done.
  My history; 49m, 6'3, 189 lbs,normal BP110/70. HR 72 Bun/cr 13/0.9, Chol 171, HDL 60, LDL 83.  GERD
  Stress EF was 31%. Wouldn't let me do tread, chemically induced. Abnormal perfusion demonstrating an apical and apical anteroseptal defect consistent with scar. Moderate inferolateral defect.Severe LV dilation.Global hypokinesis of LV. Decreased apical and mid to basal inferolateral wall thickening.
  Echo EF was 24%. Similar as above, noted addition in it - mild RA&LA enlarge, Sev reduced Global LV systolic function.  Mild aortic insuff, mild MR, TR and trace Pulmonic regurg. LV 6.94 cm.  LVEDP  23
  Catheterization EF was 15 %. NORMAL coronary arteries !  Elevated LV diatolic dysfunction.Rest similar to above displaying consistent with severely dilated cardiomyopathy.
  In addition,  experienced about 6 episodes of VT while in hosp. All non-sustained. From 10-25 beats. Constant Pvcs, multiform. Bigs, trigs, couplet, etc. Since hosp 24 hr Holter recorded 5989 multiform PVCs, with 289 couplets ( low grade 4A).
  I am in process of preparing for ICD.
  Here is what I call extremely interesting-  All the above info I purchased from hospital. The discharge summary report I just received last week because it had not yet been completed, is consistent with info.
  Since this is new to me, my cardiolist is  new, and I have been wuite impressed with him. Yesterdays visit was to up my meds, gradually trying to max them ( Low BP, HR is the issue, I believe - they knock the stuffing out of me) Meds are; Coreg, Accupril, spironolactone, and Simvastatin, ecotrin. I only saw Dr's nurse, who I am also impressed with yesterday. She explained increase amounts , times etc. After Ekg, various BP, made me walk for 3 min, etc, then tells me; disregard increasing meds. Hmmm, when I inquired, all she is willing to tell me is that the meds " are doing their job". Also she was VERY reluctant to show me results of Holter. Wasn't until I assured her that I felt Pvcs, so i wouldn't be alarmed at their frequency in report that she agreed.
  But the strangest of all, now this concerns me on various levels- if there is a nurse who may be out there and understand this and be able to explain, I would love to hear...  While she and I were going over all the info, she quotes catheter EF as 25 %. When I corrected and said no, 15 %, she shows me the copy she has. I am like what? !!!  I have my own original copy, as well as the results explained in discharge summary report from hospital. And most important, I spoke with the Cardiologist who performed catheter !!!  
  How in the world were these numbers changed? The difference being quite significant when you factor in what a percent in change it is. How does one begin to find out why/who/when this was done. Right now I am quite confused as to the condition and damage to my heart.
  I post this because I feel this is very significant. If test results can be changed, at whim, it would compromise their importance, no? And what might possibly be the  motivation as to why someone would change them? If anyone has any info or input, I welcome hearing from you.  Take care, Steve

[Sirenet]

Hi and thanks for your response. I am not sure that I understand your post correctly, but if I am close, you have certainly had your share of hell. I am sorry to hear of your experiences. I imagine that you now have an ICD? Hope that you are doing much better..

[cmb6179]

Hi, I too am a nurse-you may have seen some of my postings. I have never heard of differing #'s & opinions til my most recent cardiac issues. EF was reported at 40% since multiple cardiac arrest in 20002. Started getting symptomatic, EF by echo 30%=call from MD this is very serious, etc., devolped worsening symptoms of right sided HF-placed on 40Lasix/and Dig increased-go for cath EF47%=call from MD I don't why your so symptomatic, BNP is normal this is mild R sided HF-go to your primary there must be something else wrong-ugh-primary=perfectly normal exam, now awaiting MUGA scan results. It makes you feel like your crazy-but when I went over all my own records from 2002=multiple sudden cardiac arrest w/emergency Thoracotomy & open cardiac massage for 40min & then came back=common theme-no explaination for any/Atypical was written everywhere.  I may not fit into a box, but I know my body & I know something is not right.  Follow your gut on this one, you have to be your own advocate!! Good luck.

[Sirenet]

Hello and thank you so much for your response. The typo was what I first suspected, but she became adamant. I compared - word for word, her copy and mine. That number was all that was different. I should point out, which adds to curiosity is that this DR belongs to a heart group affiliated with hosp and many Dr's. This is why he had all my records when I saw him. Upon our first visit the low EF , 15% was discussed from cath. He acknowledged knowing the Dr who performed it, as a very good Dr.
  So somehow, either they agreed to just change it or my new cardio did. This first test result while I was still in hosp was an issue as to if they would release me without ICD at all. ( I was so blown away from new info that I said I needed time to learn/adjust/give time to sink in)...
  Thank you so much once again. Wishing you well. Enjoy your weekend.  -Steve

[maggiemag]

I understand your concern, Steve, as this kind of thing can be very frustrating.  I am an RN, and my guess is that it is a typo.  I don't think your therapy would change one iota, though, for an EF of 15% versus an EF of 25%.  You would still have an ICD recommendation.  The med doses would still be the same and may still have to be adjusted from time to time depending on your response.  Your BP may get too low or your heart rate or whatever.  I have mutlifocal PVC's, short runs of NSVT, and no ICD and no one cares.  5000 really isn't very many for 24 hours considering your LV dilitation and low EF.  I think you are on the right track and would just forget about the numbers.  We have been told that it is how you feel that matters, and once you get used to the drugs you will feel better!