Scared about DH’s heart

[Scuba]

DH had an emergency quadruple bypass in 2022. He recovered well and was told by his medical team that he should live a normal lifespan if he maintains a healthy lifestyle. He’s not overweight, he doesn’t drink any alcohol or caffeinated beverages, has never smoked, and is reasonably fit.

A few months ago, he started to experience a low/irregular heartbeat, with his pulse dropping into the 30’s at times, He went to his new cardiologist (we moved to FL last fall) who initially didn’t seem concerned, saying it was PVC’s and that they are pretty common and not dangerous. However, he did schedule DH for several tests, and DH was just informed that his Ejection Fraction measured at 40. They made an appointment for him in a couple of weeks for follow-up. They mentioned possibly adjusting his meds but don’t seem to feel the situation is urgent.

After researching this, I’m trying not to panic. An Ejection Fraction measure of 39 is considered heart failure. DH says he feels fine but being so close to a heart failure situation after his surprise surgery 2.5 years ago is scary!

If you were in this situation, would you go to the ER now or wait for the cardiologist appointment in 2 weeks? Regardless of where we end up with this cardiologist, we are thinking that getting a second opinion from a cardiologist at Tampa General would be a good idea. DH has traditional Medicare with the AARP UHC supplement, so luckily he can go virtually anywhere for evaluation/treatment.

 

[Sunset]

When I look I don't see anything to panic about. Sure it's not good news but this site says it's not so bad.

I think maybe making a phone call to see the Dr sooner, and set up a 2nd opinion appt now as may take a few weeks to get one would be good.

Ejection Fraction: What It Is, Types and Normal Range

Ejection fraction measures the amount of blood the left ventricle of the heart pumps out to your body with each heartbeat. A healthy heart has an ejection fraction of 50% to 70%.

my.clevelandclinic.org

 

[Texas Proud]

I will speak from a situation of not knowing much and might get the terminology wrong...

A few months back one of my sisters had really low heart rate... she went to a number of Drs who did not give her any confidence... she was an RN and knew something was wrong...

Finally found someone who actually did their job but told her she needed to get into the hospital right away... IIRC she had a 3rd degree block... had to insert a a pacemaker right away...

Yesterday she told me she had fired her cardiologist and when she went to see her new one told her story to him about how nobody was listening to her and if he did that to her she would 'fire his ass'...

I would get a 2nd opinion... and maybe a 3rd... the problem is that your DH does not think anything is wrong so might not want to go...

 

[Koolau]

Definitely a second opinion. When I changed cardiologists, everything got changed indicating to me that there is a lot of "art" as well as science involved.

Most important is to find someone you trust to treat the heart. Blessings and good luck.

 

[simple girl]

I would definitely get a second opinion. I hope you are able to find someone good without too long of a wait. It's tough to get appointments around here! Perhaps go see his primary care doc to see if they can assist in helping you get a second opinion appointment more efficiently. You can also get a sense of how urgent his primary doc thinks the situation is or isn't.

 

[cmc333]

I have Congestive Heart Failure with an EF of 19%. I was diagnosed June of 2020. I fired my first cardiologist because he was an idiot. I was shaky and felt "funny" the day we went to the ER. Can't really define "funny" - I was just off. As soon as I got home from the hospital, we went on a new diet, I did cardiac rehab therapy. I beat the statistics that say most people end up in hospital again within 30 days. I beat the statistics that I would die within 5 years (well, 4-1/2 years now) Three months ago I had a pacemaker with defibrillator implanted. I can't really say it has impacted my life much. Yes, I do get tired more easily, but most days I don't even think of having CHF. My cardiologist put me on 3 drugs, 2 of which are supposed to be miracle drugs for improving your EF, but they haven't improved mine. You can get a second opinion if wanted, but basically it's pretty easy (for the doctor) to diagnose.

Different people experience low EFs differently. Some with an EF of 30 can't walk to the car in the garage. Some like me, with such a low EF, don't even feel like I have CHF. Both doctors and nurses have remarked that I'm the healthiest CHF patient they've ever seen. We're not sure why I have CHF; we are assuming it's from a bout of Covid I had 6 months before.

TLR - It's a scary thing to be diagnosed with, but it's not the worst that can happen. You can have a normal life, especially with an EF of 40. So take some time to go into panic mode, then research. Just make sure you like your cardiologist and EP (if it gets to that point). It's very important to have a doctor that will listen to you and not just tick the boxes under CHF - things to do. You can PM me if you want any other info. sorry this is so long - I just thought it might make you feel better to know that people have fine lives with lower EFs.

 

[Aerides]

Yeah 2nd opinion, or call back the Cardio and push for an earlier appointment and let them know your concerns.

 

[athena53]

Definitely not an exact science. I'm dealing with an EF of 50-55% that leaves me breathless on exertion (especially going uphill walking or on a bike) but otherwise functioning pretty well. I've done the whole cardiologist/interventional cardiologist/cardiac surgeon circuit and I've got mitral valve prolapse that will eventually need surgery- basically we're waiting for it to get worse because right now the risks of surgery don't justify the potential improvement. Surgeon says the bar is high in my case because I CAN ride 20 mile son level trails and do hike up hills at a more moderate pace. I get that.

I agree with finding out what exactly is causing the low EF (in my case an echocardiogram, which is noninvasive, flagged it) and then finding out what meds, treatments and lifestyle changes can mitigate it.

 

[ivinsfan]

First of all when you say low not regular heartbeat, how did your DH notice the problem? Second there are a few ways to measure EF...an echo, an angio and a stress test. Also the skill of the tech doing the ultrasound can vary. In the echo the number is assigned by the doctor reading/looking at the pictures from the echo. So could vary depending on the doc. A lower EF can be caused by a lot of things, some serious, some not so serious. So I suspect the next move is some more reliable tests so they can be confident in the actual number. Be prepared to go to appointments with your hubby and pay close attention. But no reason to panic at this time.

There is zero point in going to the ER at this point. If something changes suddenly maybe then, but this sort of thing is fairly common.

 

[ivinsfan]

I would definitely get a second opinion. I hope you are able to find someone good without too long of a wait. It's tough to get appointments around here! Perhaps go see his primary care doc to see if they can assist in helping you get a second opinion appointment more efficiently. You can also get a sense of how urgent his primary doc thinks the situation is or isn't.

Actually a 2 week time frame for a cardio appt is pretty darn good. Particularly with Thanksgiving in the mix. People tend to get impatient but that's how long it takes in a non emergency situation.

 

[simple girl]

Actually a 2 week time frame for a cardio appt is pretty darn good. Particularly with Thanksgiving in the mix. People tend to get impatient but that's how long it takes in a non emergency situation.

I wasn't referring to the 2 wk appt follow-up time with the current cardiologist; I agree, that's actually quite fast!

I was referring to the amount of time it would take to get a second opinion with a new cardiologist. The wait times around here can be 3 or 4 months or sometimes even longer to get a new patient appointment.

 

[ivinsfan]

Oh okay I agree with that .
..

 

[Montecfo]

Hi Scuba!

I think you are right to be concerned, I would be. But if he feels good and situation is stable I would not be thinking ER.

As a heart patient with stents to show for it (and having gotten my first one 20 years ago) I have also gotten frustrated at times with cardiologists. I think part of it is they see your husband as a pretty healthy reasonably fit guy. He does not seem to them as someone needing medical intervention. They see a lot of very seriously ill patients. The rest of us seem reasonably healthy by comparison!! This is good news.

But since his cardiologist will be a very important person for his health, I would want to seek the second opinion (as soon as can
be scheduled) and possibly a new doctor that you feel more comfortable with.

Taking smart actions like the that can ease the nerves.

Wishing you both all the best!

 

[Ronstar]

OP - I’d call your cardiologist and see if your DH can get in sooner.

My heart rate gets into the 30’s several times a year - had a nuclear stress test 4 years ago that revealed pvc’s. My cardiologist wasn’t concerned and my gp doc seemed a little more concerned, telling me to get to the er stat if I get chest pains. No chest pains so far.

Good news is that your DH says that he feels fine, but I’d still try to get an earlier appointment.

 

[Scuba]

I have Congestive Heart Failure with an EF of 19%. I was diagnosed June of 2020. I fired my first cardiologist because he was an idiot. I was shaky and felt "funny" the day we went to the ER. Can't really define "funny" - I was just off. As soon as I got home from the hospital, we went on a new diet, I did cardiac rehab therapy. I beat the statistics that say most people end up in hospital again within 30 days. I beat the statistics that I would die within 5 years (well, 4-1/2 years now) Three months ago I had a pacemaker with defibrillator implanted. I can't really say it has impacted my life much. Yes, I do get tired more easily, but most days I don't even think of having CHF. My cardiologist put me on 3 drugs, 2 of which are supposed to be miracle drugs for improving your EF, but they haven't improved mine. You can get a second opinion if wanted, but basically it's pretty easy (for the doctor) to diagnose.

Different people experience low EFs differently. Some with an EF of 30 can't walk to the car in the garage. Some like me, with such a low EF, don't even feel like I have CHF. Both doctors and nurses have remarked that I'm the healthiest CHF patient they've ever seen. We're not sure why I have CHF; we are assuming it's from a bout of Covid I had 6 months before.

TLR - It's a scary thing to be diagnosed with, but it's not the worst that can happen. You can have a normal life, especially with an EF of 40. So take some time to go into panic mode, then research. Just make sure you like your cardiologist and EP (if it gets to that point). It's very important to have a doctor that will listen to you and not just tick the boxes under CHF - things to do. You can PM me if you want any other info. sorry this is so long - I just thought it might make you feel better to know that people have fine lives with lower EFs.

 

[Scuba]

Cmc333,
Thank you so much for sharing your situation. Definitely helps me feel better that there are solutions out there. I may PM you once we know more about what DH’s cardiologist recommends as next steps. I appreciate your support!

 

[Scuba]

First of all when you say low not regular heartbeat, how did your DH notice the problem? Second there are a few ways to measure EF...an echo, an angio and a stress test. Also the skill of the tech doing the ultrasound can vary. In the echo the number is assigned by the doctor reading/looking at the pictures from the echo. So could vary depending on the doc. A lower EF can be caused by a lot of things, some serious, some not so serious. So I suspect the next move is some more reliable tests so they can be confident in the actual number. Be prepared to go to appointments with your hubby and pay close attention. But no reason to panic at this time.

There is zero point in going to the ER at this point. If something changes suddenly maybe then, but this sort of thing is fairly common.

Ivinsfan, thanks, this is reassuring. DH first noticed that his pulse seemed irregular while we were in Greece this past summer. He monitored it but felt ok, so decided to wait until we returned home to go to his cardiologist. The current EF measurement was from an echocardiogram. I’m definitely going to his follow-up appointment on December 4.

 

[Scuba]

Thank you to those who commented. I feel a little bit less nervous and we decided to wait until his December 4 appointment to assess next steps. In the meantime we will make some calls to schedule a second opinion, realizing that that may take months to get.

DH is willing and interested in getting another opinion, as he definitely wants to live a good quality of life and do whatever he can to support that goal. Fortunately he feels fine and is not short of breath even when exercising so we will hope for the best.

I appreciate everyone helping me to avoid melting down, I’m trying to be strong for DH, but the idea of losing him sends me into a tailspin if I allow myself to think about it. I know there is a good chance I’ll outlive him, but I’m hoping for many more good years together before that happens.

 

[Gremlin]

Thank you to those who commented. I feel a little bit less nervous and we decided to wait until his December 4 appointment to assess next steps. In the meantime we will make some calls to schedule a second opinion, realizing that that may take months to get.

DH is willing and interested in getting another opinion, as he definitely wants to live a good quality of life and do whatever he can to support that goal. Fortunately he feels fine and is not short of breath even when exercising so we will hope for the best.

I appreciate everyone helping me to avoid melting down, I’m trying to be strong for DH, but the idea of losing him sends me into a tailspin if I allow myself to think about it. I know there is a good chance I’ll outlive him, but I’m hoping for many more good years together before that happens.

I think your plan is sound. Wishing you and your DH all the best.

 

[Scuba]

We got a second opinion appointment but not until March. On a cancellation list in case anything comes up sooner. In the meantime we have our local appointment next week. DH continues to feel fine.

 

[athena53]

Does DH have a smartwatch? My Apple watch measures blood oxygen, heart rate, VO2 Max, will do EKGs and is supposedly good at detecting atrial fibrillation (not a problem of mine, I'm happy to say).

I have to confess I haven't checked these things regularly but that's a good sign- I'm a bit of a hypochondriac. It may help you to get an idea of what's "normal" so you can take action if something changes drastically.

 

[Scuba]

Does DH have a smartwatch? My Apple watch measures blood oxygen, heart rate, VO2 Max, will do EKGs and is supposedly good at detecting atrial fibrillation (not a problem of mine, I'm happy to say).

I have to confess I haven't checked these things regularly but that's a good sign- I'm a bit of a hypochondriac. It may help you to get an idea of what's "normal" so you can take action if something changes drastically.

Yes he does, and that helps him monitor his situation. One of the alarming things it helped him note is how often his heartbeat dropped into the 30’s. Yikes!!

 

[athena53]

Here's an info source you might want to try- doctronic.ai. It showed up in my FB feed. It's artificial-intelligence driven and you can ask questions about a particular medical condition or even input symptoms and ask for a diagnosis. It's free but they offer a consult with a medical person for $29. No registration needed.

It did a pretty good job with my heart condition- nothing I'd change since I'm already getting the monitoring and testing it recommended.

 

[Koolau]

Here's an info source you might want to try- doctronic.ai. It showed up in my FB feed. It's artificial-intelligence driven and you can ask questions about a particular medical condition or even input symptoms and ask for a diagnosis. It's free but they offer a consult with a medical person for $29. No registration needed.

It did a pretty good job with my heart condition- nothing I'd change since I'm already getting the monitoring and testing it recommended.

I wonder about unofficial privacy and especially HIPPA privacy when using something like this. Does using it allow them to sell your info, etc.?

Thanks for the site.

 

[Scuba]

Here's an info source you might want to try- doctronic.ai. It showed up in my FB feed. It's artificial-intelligence driven and you can ask questions about a particular medical condition or even input symptoms and ask for a diagnosis. It's free but they offer a consult with a medical person for $29. No registration needed.

It did a pretty good job with my heart condition- nothing I'd change since I'm already getting the monitoring and testing it recommended.

Thanks, very interesting. Never heard of this. Sounds like it’s worth checking out.