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Forum Name: Cardiology Diagnostics

Question: ECHO - Why? What are they looking for?


 QuietOne - Fri May 27, 2005 2:10 am

I turned 36 today. Yesterday, I had a second follow-up with my internist regarding chest pain (midline and to the right) and shortness of breath. On the first visit, he tapped my back and listened to me breathe. He had wondered about asthma, but the ENT tried to treat me for asthma with AdVair the week before, with no change in my condition. The doctor wondered about viral pleurisy, and wanted me to wait a few more days, which I did, but today he has ruled that out.

Today, the chest x-rays read as normal, as did the EKG. They drew blood - I don't know what to test for. He then listened to my heart with his stethoscope and got kind of quiet. He said something about hearing a murmur. He didn't say what level or anything. Next week, I am being sent for a Stress ECHO, but the doctor was very non-talkative about why I am going for the test. I know that he cannot say something without being sure after tests, but he only said that they were "ruling things out". I have no history of heart trouble. I am on meds for depression and hypothyroidism, but am an otherwise healthy person.

What am I missing here? What are they looking for with the ECHO? What are the odds of something actually being wrong with my heart? This is going to be a long week to wait until the tests, and then another long wait to see the doc again.

I'm not looking for a diagnosis here, but in all reality, what could they be looking for in a healthy 36 year old woman with no heart trouble history? Thanks for any info that you can offer.
 Dr. Wafaa Abdel-Hadi - Fri May 27, 2005 2:29 am

Dear QuietOne,

A Stress Echo is a very important test...as you can see the Heart's walls,valves ,power of contraction...etc. So don't worry until there's is something tp worry about... your Chest pain can be related to as simple as anxiety, or gatric troubles(oespophagitis), quite a long list, so he just wants to check on your heart first.

Hearing a murmur on the heart is not necessarily something bad.... alot of normal healthy people have mitral or tricuspid valve regurge and not causing them troubles. It's the degree of the regurge that matters ....or the stenosis.

I don't want to fill your head with ideas...just please wait for the test to be done,ok?

Best regards,
 QuietOne - Fri May 27, 2005 9:34 am

Thanks for the information, Doctor. I am not worrying too much about it, but the doc stopped looking me in the eyes when he was talking to me - maybe he was just concentrating and thinking. It was strange feeling - that got me a bit more frightened than hearing that I need more tests.

I like my doctor and will trust him to do what he thinks needs to be done. If something pops up, there are always second opinions, but he is very capable and has a great bedside manner.

I can't even begin to understand what might be causing my chest pain and breathing troubles - good thing that I'm not a doc, so I'll leave it up to folks who know what they're doing.

You have put me more at ease, and I appreciate that very much. Now, it's time for cake and gifts. A happy day to you and all. :)
 QuietOne - Mon May 30, 2005 3:28 pm

Just posting to hear myself "talk". Even though I'm not terribly stressed about whatever my problem is, it is not easy to wait... mostly it's not easy to wait because I just don't feel well and want to figure out a way to start feeling better. The waiting game is frustrating. I'm not running through horrible scenarios in my mind, but taking it easy because you don't feel well is enough to make you go nuts - no matter what is happening in your body.

I am also readying myself for the tests in regards to my own sense of modesty. I do not like to be "uncovered" in any public (and YES - the doctor's office is public, with different people who come and go) situation. I sucked it up and made it through the chest x-rays and EKG last week, but I didn't have much time to think about it.

I know that "these people are professionals and they do this every day", but I don't... and it is important to me that they take measures to make me as covered-up and comfortable as the test will allow.

I know that they need to be able to "get to" different parts of me before, during and after the tests, but I would also like them to stop their assembly line procedure long enough to realize that I may have modesty issues that are different from their last patient... or from their own. I find that medical folks often have no concept of their patients' attitudes and beliefs, and I think that is careless and insenstitive.

I won't hold up the testing and get them off schedule, but I will be asking for some assistance in maintaining my modesty as much as the situation will allow. I am a very compliant patient, but this is one area where I will ask for something that they may not consider a big deal.

How pathetic is it that the procedure of the testing is more troubling to me than the results at this point?

Also sending out a kind thought to anyone who is reading this - I guess you wouldn't be looking around this site if you or a loved one weren't having a situation of your own. Good luck and take care.[/b]
 QuietOne - Sat Jun 04, 2005 10:55 pm

Just popping in with an update - meager as it is.

The doctor called me today (on a Saturday afternoon - weird) and said that the stress ECHO had been sent to the cardiologist (we don't have one in my town) and that he had seen something that "didn't look quite right" with an inferior vessel. My doc wants me to see the cardiologist - they'll set up and appointment and call to tell me when.

I want to talk to my doctor and ask him about some options, and whether he wants to take on part of this or not. I still have a very specific pain in my back - right side, mid back in the rib area - and I'd like to know what that is about. If they are going to want me to lie down for any kind of tests that take more than a few minutes, we're going to have to work on that spot first. I'd like to know if it is related to the chest pain.

I don't know if the cardiologist wants to mess around with some of this, or if my doctor will refer me to someone else first. I was wondering about having:

-X-rays that would be read by an osteopath or someone else in the bone/muscle field.

-An MRI to see if there is anything happening that shouldn't be. (They can do contrast, etc. right?)

-Another stress ECHO so that they can check that vessel.

I don't know who would handle the different areas/tests, but I will ask the doc and see what he says. My doc mentioned an angio, but he said that the cardiologist would decide that. (I hope that I get to decide that, too.) That's a pretty invasive procedure and I think that there is a lot between where I am now and that test.

I am apparently not in any danger, so I don't need to rush into anything. My chest is pretty dang painful and I'm moving slower than my 92 year old grandma, but I want to make sure that we touch all of the bases.

I don't know anything about cardiologists and their reputations. Will there be some good bedside manners or will I be on the assembly line? I'm all for efficency, but not at the expense of my health care.

I'll update when I get more info. If the kind doctor here would like to put in a few words, I'd be happy to hear something.

As I've been saying: I don't feel sick at all... except that I feel like I'm going to drop dead.

:roll:

Have a good day, all.
 pt_i_am - Thu Jan 12, 2006 8:03 pm

Does it mean anything if your ejection fraction goes from a 70% in one month to a 58% three months later? I know they are both normal, but is it supposed to drop that far?

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