I haven't seen the cardiologist yet, but my family doc did give me the results of my last 2 tests. QUite confusing to say the least. This is what the first one said:
MUGA done July 26 ... they are calling it :Left Ventricular Wall Motion Study
The first transient images show a normal sequence of activity through the cardiopulmonary structures. The right ventricular ejection fraction could not be calculated for technical reasons likely related to poor cardiac output.
The gated equilibrium study was obtained in three projections. This shows a moderately dilated left ventricle. The apex is akinetic. The remainder of the left ventricle is moderately to markedly decreased. Global ejection fraction is calculated at 23%.
Opinion: Moderate left ventricular enlargement. Moderate to marked global hypokinesis with apical akinesis and left ventricular ejection fraction of 23%.
An ejection fraction of 23 is not good, I was really hoping for better. The second test was a CT Angio done last wednesday. Here is the prelimanary report on that:
Cardiac CT: CT Angiography
REASON FOR STUDY: Probably dilated cardiomyopathy. Has diabetes. Rule out coronary artery disease.
IMAGING HEART RATE: 45. BPM BP: 100/89 mmHg.
ECG: Normal sinus rhythm.
TECHNICAL FACTORS: CT ANGIOGRAM: The patient's heart rate was optimized using intravenous beta-blockers. Sublingual nitroglycerin (0.8mg) was also administered. Retrospective ECG gated cardiac CT images with IV contrast were acquired during an inspiratory breath hold. Timing bolus was performed to optimize opacification of the coronary arteries. The interpretation was performed using the cardiac phase with the best axial, MPR, curved MPR and MIP images.
Total IV contrast: 100cc.
IMAGE INTERPRETATION - CT ANGIOGRAM:
CORONARY STENOSES: None
NON-EVALUABLE SEGMENTS: None
NON-STENOTIC ATHEROSCLEROTIC PLAQUE: None
LV EJECTION FRACTION: 40%
LV END DIASTOLIC VOLUME 185 CC.
LV END SYSTOLIC VOLUME 111 CC.
REGIONAL WALL MOTION: Moderate global hypokinesia
INCIDENTAL FINDINGS: The mediastinum, lungs, pleura and chest wall were included from just below the carina to the lung bases.
There is no hilar or mediastinal lymph node enlargement. The pulmonary parenchyma, pleura and chest wall are normal. There is a small pericardial effusion.
1. Abnormal study
2. CT ANGIOGRAPHY: Normal
3. LV FUNCTION: Moderate global hypokinesia
4. INCIDENTAL FINDINGS: Small pericardial effusion
The ejection fraction on this one is 40% ... this is where the confusion comes it. Did I really improve that much in 1 month, after only going up 3% in the 2 1/2 months prior to the first one?? Or is one more accurate than the other ... and if so, which one??? ugh. I can't wait to see my cardio on the 30th. The pericardial effusion has me somewhat worried also . I have no clue if he will allow me to return to work or not, but I really hope he does.
On a more positive note, we bought a van. It's a 2003 Chevy Venture, and I'm loving it. It's so much easier to get the kids in and out, and rides soo smooth. It's not new, but it's the newest vehicle I've ever owned. It even has a built in DVD player, that Lex is just loving .
Well, that's it for now. Kev is now on overnight shifts, and I'm hating that, but only a week and a half to go, thankfully!!!!! It'll be strange sharing the bed again though lol.
I saw the cardiologist today, and it was overall a good appointment. He listened to my heart for a good 10 minutes and could NOT find the S3 gallop, woohoo. He explained the difference in the ejection fractions from the 2 tests as being the result of the MVR, and the the MVR would cause the reading of the EF on the MUGA test to be low. He believes I'm more in the 40% range. He will be repeating the echo though to make sure. The pericardial effusion he believes to be insignifant, and not related to the cardiomyopathy, but again he will look for it at my next echo. He has now classified my CHF and functional class 1 ... woohoo again. My altace is being increased again, so I'll be feeling crappy for a little while. After my next echo I may get the ok to return to work part time ... woohoo again, not that I like working, but knowing that I'm healthy enough to be working is such an emotional relief .
Started Cardiac Rehab today .... I hurt where I didn't know I had muscles. What an adventure that was. I go to the Heart Institute for my rehab, it is part of a big hospital complex, that is currently all under construction. Of course there was no parking left at the Heart Institute, so I had to go to the main parking garage of the hospital itself. Wound up parking on the roof, and walking down 5 flights of stairs, then 3 blocks to get to Heart Institute. Then up another 2 flights of stairs to get to the track ... by the time I got there my pulse was at 90 . I had to start with a gentle walk, then increase to a brisk walk. My pulse went up to 136, which freaked out the PT. She had me go back to stroll mode and my hr went down to 108, she was much happier with that. My target is from 20 to 30 over my resting hr. My normal resting is 65ish. so I more than doubled it.
I then continued on with floor exercises and stretches, and now I am reminded that I have muscles that I didn't know existed, especially in the side of my right foot, what a weird place to hurt. Looking forward to getting that "kick in the keister" to get me moving though.
I have another echo booked for Monday, then I see the cardio on Oct. 2 to get my results. If they are good then i get to go back to work part time ... woohoo lol ... NOT. But, the mental health of knowing I am healthy enough to return to work will be nice ... lets hope for a good echo test.
Kevin has his vasectomy scheduled for Thursday at noon. It's really sad to say a final goodbye to that part of my life. No more babies, but at the same time that is somewhat of a relief... no more midnight feedings, no more bottles, soon no more diapers , leave that to both my SIL's who are currently preggo. I can now enjoy the next phase of my life watching my babies grow up. god willing I'll be around for a long time to see them.
Saw the cardiologist today. He has given me the ok to return to work part time, being 6 hours day 3 days a week, untill I feel up to returning full time.
My heart is doing well overall, my size although still enlarged has come down, and contractability is stronger and doing better. No need for an ICD at the moment
He is somewhat baffled over 1 thing. The echo showed moderate to severe mitral regurgitation. He can see it on the echo, but the valve itself looks fine, and he can't hear the murmur that he should be hearing with that much regurg. He's thinking the enlargement of my heart caused the skeletal frame to enlarge and hoping that it'll get better as my heart gets better. If not I may be looking at valve repair/replacement in the future.
He will be presenting my case when his next staff meeting occurs to get the opinions of other cardio's.
Once again, I am proving to be what my PCP once called me ... a "Medical Disaster" lol. All in good fun she called me that