Echocardiogram Results

 

I had my meeting with my GP yesterday afternoon, to discuss the report from my echocardiogram on February 25th 25. I scanned in the hard copy (little is electronically joined up in today's NHS) and asked ChatGPT to summarise the report and its implications.

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Summary of Echocardiogram Report (25 Feb 2025)     ---    [ChatGPT]

Key Findings

Heart Rhythm: Sinus rhythm, resting heart rate 58 bpm, with rare ventricular extrasystoles.

Left Ventricle: Normal size, normal systolic function (ejection fraction 57%), no regional wall motion abnormalities.

Right Ventricle: Normal size and function.

Mitral Valve: Thickened, fleshy leaflets with bi-leaflet bowing, opening well. Mild to moderate mitral regurgitation (MR) (vena contracta = 0.37 cm).

Aortic Valve: Normal trileaflet structure, thin and mobile leaflets, no significant stenosis or obstruction.

Tricuspid Valve: Thin and mobile, mild regurgitation, no signs of pulmonary hypertension.

Pulmonary Valve: Normal structure, trivial regurgitation.

Left Atrium: Normal size.

Inferior Vena Cava: Dilated but collapses less than 50% on sniffing (suggests mildly raised right atrial pressure).

No pericardial or pleural effusion.

Interpretation & Comments on Your Decision

1. Severity of Mitral Regurgitation

Your mitral regurgitation is mild to moderate, which is reassuring. In more severe cases, MR can lead to symptoms such as fatigue, worsening shortness of breath, and atrial fibrillation due to left atrial enlargement. However, your report suggests your heart function remains strong, and there’s no major impact on chamber size or overall circulation.

2. Implications of Mild to Moderate MR

Low immediate risk: Given your normal ejection fraction (57%) and the absence of significant left atrial enlargement or pulmonary hypertension, there’s no immediate concern.

Potential for progression: Mitral regurgitation can worsen over time, so monitoring symptoms is key. If breathlessness on exertion (SOBOE) worsens, a repeat echocardiogram in a year or two might be prudent.

Minimal impact on daily life: Your exercise tolerance may remain stable, though you should note any changes in fatigue, breathlessness, or irregular heartbeats.

3. Decision to Cancel the May Cardiologist Appointment

Your reasoning is understandable. The cardiologist would likely only suggest medications (e.g., beta-blockers, ACE inhibitors, diuretics) to reduce heart strain, and given the mild nature of your condition, these might not be necessary at this stage. You’re also right to consider quality of life—many cardiac medications come with side effects that may not be worth it for a condition that currently seems stable.

That said, if your symptoms progress (e.g., worsening breathlessness, palpitations, or fatigue), reconsidering follow-up in the future would be wise.

4. Recommendations Going Forward

Monitor symptoms: If you notice worsening exercise tolerance or arrhythmias, reassess.

Repeat echocardiogram: Consider one in 1–2 years to track any progression.

Lifestyle: Maintain heart-healthy habits (moderate exercise, balanced diet, hydration).

Blood pressure monitoring: Since low BP may play a role in your scotomas, keeping an eye on it is sensible.

Final Thoughts

Your echocardiogram is reassuring, showing only mild-moderate MR without major consequences. Your decision to avoid unnecessary medication is reasonable, provided you keep an eye on symptoms. If anything changes, a repeat scan in the future would be a logical step.

[I am booked in for a repeat echocardiogram in two years time.]

Visual field problem

 Dated: Sunday 26th January 2025

Yesterday evening I was watching TV in a low-lit room when suddenly the lower left half of my visual field vanished from my right eye. It had been replaced by what appeared to be a grey rectangle stretching from the lower left boundary of my visual field about two thirds of the way across.

There was a quite clear right-angled edge to the rectangle, just to the right of the lower-centre of my visual field. This sudden transition to partial visual occlusion was painless but I had a 'funny feeling' in my head as it happened.

After ten minutes or so the occluding rectangle vanished, although for a few subsequent minutes there was a flickering at the bottom-centre of my right visual field, as if I were seeing things there through rippling waves. But this too soon passed and my vision returned to normal. This is not the first time this has happened although episodes are spaced months apart (to-date).

I also quite often (weekly to monthly - for a number of years) have those jagged scintillating patterns which grow in size for maybe fifteen minutes before vanishing. Also accompanied by a 'funny feeling' in my head. I have put these down to a migraine aura - scotoma which I first started experiencing in 2016.

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ChatGPT is quite worried about all this ("What you’re describing strongly suggests a transient ischemic attack (TIA) involving the visual cortex or the blood supply to the retina of the right eye. TIAs are temporary episodes of reduced blood flow to a part of the brain or retina, often called “mini-strokes.”") but I'm inclined to add it to my list of concerns when I see the cardiologist in May 2025. But I will also take this note (not the ChatGPT part) around to the GP surgery tomorrow morning.

Summary of My Heart Murmur Condition (2024/25)

 

My Heart Murmur Condition (Mitral Regurgitation - MR)

History

• December 2024: This all came about following Clare's heart attack in late November. I had put my breathlessness down to long COVID but I was pressured by family to get it checked out by my GP.

  He listened to what I had to say and I thought he was just going to nod and let me go when he said, "Right, let's examine you." The usual tests: blood pressure, pulse rate and then the stethoscope; and then he casually asked, "Do you know what a heart murmur is?"

  I did not. And so we progressed: diagnostic tests were scheduled to investigate a suspected heart murmur, including an ECG and BNP blood test.

• Results: BNP levels were normal (indicating no heart damage). ECG was also normal, showing only a known slow heart rate. Kidney function was monitored, revealing eGFR of 85 mL/min/1.73m² (CKD Stage G2) and potassium level of 5.6 mmol/L (mildly elevated).

January 3, 2025: During a follow-up phone call, my GP confirmed all tests were within normal ranges. However, he suspects a leaky mitral valve (MR). He said there was little immediate risk, with advice to maintain normal activities while remaining mindful of potential acute events (with low probability - dial 999!).

Current Situation (January 2025)

• The heart murmur is suspected to be mitral regurgitation (MR) - it may well be age-related.
• Diagnostic findings to date:
  • Normal BNP levels, suggesting no heart failure or damage.
  • Normal ECG, apart from bradycardia (slow heart rate), already known.
  • No immediate risk flagged, but further investigation needed.

  Future Arrangements

  • Spring 2025: Echocardiogram to be scheduled for detailed imaging of heart structures and function.
  • May 2025: Cardiology referral at Musgrove Park Hospital for further evaluation and management of the suspected MR.