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 It had been replaced by what appeared to be a grey rectangle stretching from the lower left boundary of my visual field about two thirds of the way across.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.