Robert’s Heart

Last week my cardiologist was on vacation and I was curious about my MRI results. So, I called the imaging center and asked them to fax me a copy of the report. They can’t do that without my doctor’s OK. Hmm… I’m pretty certain I have a right to my medical records, but I’d rather get them than fight about it. So I asked if they could fax them to an alternate doctor and the answer was absolutely yes. So, I had them fax it to my aunt who is an M.D. Not much to my surprise, the records showed up on my fax within a few minutes.

I read the report and I was surprised to find that there were some abnormalities observed. I truly expected that, after all the other tests, there would be nothing of interest on the MRI. A few of the terms are downright concerning (at least from my perspective).

“Aneurysm,” “borderline systolic,” “akinesis” were all used to describe parts of my right ventricle. The report also indicated a 40% ejection fraction for the right ventricle which is marginal at best.  I should add that the “aneurysm” was qualified by a normal cardiac wall thickness (the thickness of the muscle) which indicates the aneurysm is likely an artery.  From my “google understanding” coronary artery aneurysms rarely burst because they are supported by the pericardium (the sack which surrounds the heart).  That makes me feel a lot better… really.

After discussing with my aunt we agreed that there was probably no reason for immediate concern. However I should contact the cardiologist’s office and make sure that the covering cardiologist has reviewed the results.

Their office had not reviewed the results and I had to specifically indicate that I knew something was abnormal and that they should probably review it to make sure it wasn’t an emergency issue. The covering cardiologist did review the report and indicated it could wait for my cardiologist to return.

So now I wait

As of today, Tuesday August 19th, I haven’t yet heard from the cardiologist. I’ll give his office a call today to see if I can get some results.

WOW!  Didn’t expect the cardiac MRI to last that long.  One hour and fifty minutes is a long time to have to lay still on a cold hard table.  The technician set  me up with some tunes (Pink Floyd, Dark Side of the Moon) to pass the time, but my arms got tired quickly of sitting in one place and it got really uncomfortable real quick.  Not to mention that breathing in and holding my breath for 15 seconds out of every 30 seconds was starting to make me a bit loopy.  I knew it was getting long when “Breathe” came on for the SECOND time (no reference to my breathing in and out over and over intended… really).  Then “Time,” and “Money” for a second time.  “The Great Gig in the Sky” was in there too, but you can’t help but remember the beginning of both “Time” and “Money.”  He then switched me to some U2… a nice change, but I’d like to be off the table.  Anyway, this post is starting to feel like my time on the table.  I’ll be picking up a copy of the MRI on CD.  I don’t know if I can make it available on this site yet.  If I can I will.

At about 75 minutes into the MRI the tech got the imaging center’s cardiologist to come look at the photos.  Presumably to check and see if there was anything of interest which needed further imaging.  After about 15 minutes of waiting we got back to it and took a bunch more images.  Seems there was some question about what could be fat in or around the pericardium.  Unfortunately I don’t really remember the conversation that well.  So I’ll, uncharacteristically, wait for the results instead of guessing

I just received a phone call from my cardiologist (actually a cardiac electrophysiologist). He called to review my Nuclear Stress Test results. All good news! Stress test itself showed no arrhythmias and the tomographic images showed good blood flow to the heart. This indicates that the arrhythmias are not life threatening. This is what I expected, but still good to have positive evidence :-). I’m still going to do the cardiac MRI next week to rule out any other issues. I’ll post those results when I have them.

So, on 12/30/07 I finally caught an SVT on the monitor (ECG: 12/30/07 SVT), that’s great. The problem is, that evening, I kept having them. While it was a bit uncomfortable it did give me an opportunity to capture some good information. Later in the evening on 12/30 I was monitoring myself when I caught a complete SVT and more… This SVT was particularly painful and had a feeling of significant pressure in my chest in addition to the usual light headed feeling. At about three and a half minutes into the SVT the pain and pressure went away, but I still had the arrhythmic feeling in my chest. The ECG still showed an arrhythmia, but it wasn’t regular like the SVT. The next morning my mom identified the irregular rhythm as Atrial Fibrillation. FYI My mom is a retired cardiac care nurse who has been a big help for me to understand (in a novice kinda way) what I’m looking at on the ECGs.

This strip (Click Here For The ECG) shows the beginning of the SVT. At about 14 seconds on that strip a “glitch” in the SVT causes it to speed up from what was 190 BPM to 232 BPM. That’s when the SVT became particularly uncomfortable.

This strip (Click Here For The ECG) shows the conversion from SVT to AF. It is pretty noisy because I was moving around at the time. After a few minutes the AF settled into about 140 BPM (Click Here For The ECG) and lasted for at least 15 minutes when I stopped monitoring. It did eventually, spontaneously, convert to a sinus rhythm.