Opinion wanted - back from cardiologist spec.

[M@NU]

Hey guys,
i saw my "village-cardiologist" yesterday to discuss the 24 hour ecg results. Unfortunately, they were not available yet (they are sent out of house for analysis).
After that, we briefly talked about the stress mrt. (or cardio mrt).
She pretty much made me a bit scary abou the whole thing
(told me more or less she thinks it is not necessary and has risks such as kidney failure and more..?)
can anyone who already had one of those stress/cardio mrts share your experience?
thanks!!

 

[MyNameIsJeff]

Some of the MRI contrast agents can have adverse health effects, mainly in people with impaired kidney function. I don't know which contrast agent would be used by your radiologist, but there appear to be a number of choices. My guess as a layperson is that given that your kidneys are doing OK atm, they should be able to find a suitable contrast agent for you.

Another reason that your cardiologist may try to dissuade you is that cardiac MRIs are expensive. With your lovely socialized medicine in Europe, the doctor will have to put a lot of work into convincing the health insurer that this procedure is necessary.

 

[M@NU]

Some of the MRI contrast agents can have adverse health effects, mainly in people with impaired kidney function. I don't know which contrast agent would be used by your radiologist, but there appear to be a number of choices. My guess as a layperson is that given that your kidneys are doing OK atm, they should be able to find a suitable contrast agent for you.

Another reason that your cardiologist may try to dissuade you is that cardiac MRIs are expensive. With your lovely socialized medicine in Europe, the doctor will have to put a lot of work into convincing the health insurer that this procedure is necessary.

Hey Jeff,
i was told the contrast agent was not really dangerous but the adenosine injection could be dangerous for the heart?!
Well, your second point could be right because my "family cardiologist" is the one who should give me the letter of referal.. and not the specialist cardiologist whose idea it was

 

[MyNameIsJeff]

Well you referred to kidney failure above, and that's a side effect associated with some contrast agents but not adenosine.

Adenosine as part of a 'Cardiac MRI Adenosine Stress Test' is safe unless you have some super rare contraindication. Plus, in the freak case that you do get say a heart attack during the stress test, your survival chances for that in a hospital are pretty darn good. See the paper below, if your cardiologists are diligent and somewhat competent, then the procedure is safe.

65 year old woman with history of ischaemic heart disease underwent standard adenosine stress test for myocardial perfusion imaging. She sustained inferior myocardial infarction during the final stages of the stress test. She was admitted to the coronary care unit and received thrombolytic treatment. The patient made an uneventful recovery. Adenosine is widely used for myocardial stress imaging tests and has a good safety profile. So far there has been only one other reported myocardial infarction during adenosine stress test, which was under special circumstances because three days before the test the patient had undergone percutaneous transluminal coronary angioplasty when a severe circumferential dissection was noted. The present patient's case highlights the need to be aware of rare but potentially serious complications of adenosine, even though it generally has an excellent safety record for use in myocardial stress testing.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1767004/

 

[maldorf]

I would be concerned because of the lower than normal EF, akinesis in the left ventricle, and the LV is dilated. Akinesis of the heart wall means that it is stiffer than it should be and really not squeezing like it should, hence lower than normal EF. Your heart wall isn't moving as much as it should. That is what I have now after my heart attack. You haven't had a heart attack though and your EF is more than 2x what mine is.

I had something very similar to what you have, about the same EF, and they just call that idiopathic cardiomyopathy. I got off all steroids and within 10 months or so my EF was back up to between 55 and 60%, normal.

My problem was that a few months later I got back on that shit and then had a heart attack years later. Here I am today.

 

[M@NU]

I would be concerned because of the lower than normal EF, akinesis in the left ventricle, and the LV is dilated. Akinesis of the heart wall means that it is stiffer than it should be and really not squeezing like it should, hence lower than normal EF. Your heart wall isn't moving as much as it should. That is what I have now after my heart attack. You haven't had a heart attack though and your EF is more than 2x what mine is.

I had something very similar to what you have, about the same EF, and they just call that idiopathic cardiomyopathy. I got off all steroids and within 10 months or so my EF was back up to between 55 and 60%, normal.

My problem was that a few months later I got back on that shit and then had a heart attack years later. Here I am today.

yeah maldorf, i already read your whole thread up and down several times and know about your issue. I am glad you are doing well, although the recent event with the defi is not really great..
I have added ubiquinol at 400mg and d-ribose at several grams daily again.
what i am feeling in the recent 3 weeks is a huge increase in endurance. I do my cardio and i have opted to do 4x intervall training (not hiit but HR between 130 and 160, 45s rest 1min fast) and 2x SS LISS (40-60min).
I dont know why my endurance is like crazy recently but i am not mad about it ..
Another thing i did is to reduce training weights and go with a faster pace. (every third session for groups is heavier with more rest).
and i am still cutting and try to lose another 2-3kg but it is getting harder ..

I am glad that my EF didnt drop any further from august until now. Stayed exactly the same, probably the candesartan is doing its job.
I guess as long as i keep my BP and HR under control (doc said HR is very important, mine is below 50 when resting) i should do fine.
No more crazy stimulant use of course, i think this was the culprit to the whole shit... DMAA, DMBA, AMP Citrate, Yohimbine high dosed (made my heart feel like it would explode) and so on..

 

[maldorf]

yeah maldorf, i already read your whole thread up and down several times and know about your issue. I am glad you are doing well, although the recent event with the defi is not really great..
I have added ubiquinol at 400mg and d-ribose at several grams daily again.
what i am feeling in the recent 3 weeks is a huge increase in endurance. I do my cardio and i have opted to do 4x intervall training (not hiit but HR between 130 and 160, 45s rest 1min fast) and 2x SS LISS (40-60min).
I dont know why my endurance is like crazy recently but i am not mad about it ..
Another thing i did is to reduce training weights and go with a faster pace. (every third session for groups is heavier with more rest).
and i am still cutting and try to lose another 2-3kg but it is getting harder ..

I am glad that my EF didnt drop any further from august until now. Stayed exactly the same, probably the candesartan is doing its job.
I guess as long as i keep my BP and HR under control (doc said HR is very important, mine is below 50 when resting) i should do fine.
No more crazy stimulant use of course, i think this was the culprit to the whole shit... DMAA, DMBA, AMP Citrate, Yohimbine high dosed (made my heart feel like it would explode) and so on..

Sounds like you are on the right path. If you are like me before my heart attack you may recover your ejection fraction back to normal again. I had the akinesis like you, wall motion was crappy and EF of around 40%. 10 months later it was normal. I hope you recover yours. Just be smart and do not do what you did to get where you are now. Those supplements should be avoided like you are doing. If you took steroids I would kiss those goodbye. Best thing you could ever do for yourself. Only way I would consider it is if your testosterone level is low and you need HRT. True HRT from a doc, about 100 mg/wk.

 

[M@NU]

Sounds like you are on the right path. If you are like me before my heart attack you may recover your ejection fraction back to normal again. I had the akinesis like you, wall motion was crappy and EF of around 40%. 10 months later it was normal. I hope you recover yours. Just be smart and do not do what you did to get where you are now. Those supplements should be avoided like you are doing. If you took steroids I would kiss those goodbye. Best thing you could ever do for yourself. Only way I would consider it is if your testosterone level is low and you need HRT. True HRT from a doc, about 100 mg/wk.

I hope so Also hoping the best for you bro!
Well, my testosterone is low with about 9,7 (normal value starts @ 12). So is my estrogen (due to low test i guess?)..
I had a "short course" of TRT but doc insisted on 250/ e3w and it didnt work well with me due to huge jumps on hormone lvls.
I could not bring him to make it 100 e7d or something similar, neither did he wanted to prescribe gels/cremes to me.
So now i live with the value and i guess i am doing just fine..

 

[M@NU]

okay, hospital called that my appointment will be next week friday instead of 15.2 (stress MRT).
Have to get bloods (creatinine and GFR) now.
Im kinda scared about the test but i guess it is better to do it now than to regret it later..

 

[M@NU]

Short Update:

Stress Mri done 2 hours ago.
Was not as pleasing as i hoped it to be . 2 infusions (one being a big needle for the contrast dye - one of the safest ones i was told, something like "godavist" , a non linear dye(??).
It all started easy, just some commands about how to breath and when to stop to breath.
After some minutes (10 i guess) they began the contrast dye and the adenosin infusion. First i have felt nothing, doc came a second time to adjust and suddenly i felt pretty crappy: tight feeling around chest, heavy breathing and so on. Thought more than once about pressing the alarm button.
The contrast dye was mixed with saline i was told and the amount they injected was pretty much, my whole left arm turned cold and my hand was numb .
the whole procedure took around 40 minutes. After i was moved out of the mri they watched me and told me that my heart rate went pretty high after the doc adjusted the infusion because the first amount was too low for my resting heart rate to bring it up xD
Feeling ok but slightly tired now. I have felt wired and nauseated the first 20min after the test but it is better now..Will go to gym later today for a easy shoulder / cardio session.
I will get results next month. But she already told me that there are no circulatory disorders and my heart is fit from a resting heart rate standpoint (around 48 and it is not easy to get it high but possible, she told me thats good).
But the mri also agreed to the ecgs and ultrasound scans that my heart is dilated and my ef is not where it should be.
I can keep sports up but should try to make it 50:50 weighs:cardio (which i almost do right now, 6 hours weights, 4 hours cardio a week)
will post the results here as soon as i have them

 

[King-kong]

How about you listen to your cardiologist? You are not taking steroids, so noone here will have any expertise that the doctor does not. [/B]

I disagree here but do understand what you mean. Not everyone is lucky enough to have a great doctor. Some patients are just another patient to some doctors. Just one of thousands. Quite often the doc looks at the patient chart fifteen seconds before he walks in to meet the patient. I am completely blown away by how incredibly intelligent some of the members are on their forum. I realize it isn't a medical forum but there are some members on here whose opinions or advice is better than most doctors.

 

[M@NU]

I disagree here but do understand what you mean. Not everyone is lucky enough to have a great doctor. Some patients are just another patient to some doctors. Just one of thousands. Quite often the doc looks at the patient chart fifteen seconds before he walks in to meet the patient. I am completely blown away by how incredibly intelligent some of the members are on their forum. I realize it isn't a medical forum but there are some members on here whose opinions or advice is better than most doctors.

I completely agree with everything you said.
Most docs just know about the "norm".. and we athletes are not the norm
(same with blood values, ck values of several thousand are not rare if you weightlift regularly.. yet docs go crzy)

 

[nothuman]

I disagree here but do understand what you mean. Not everyone is lucky enough to have a great doctor. Some patients are just another patient to some doctors. Just one of thousands. Quite often the doc looks at the patient chart fifteen seconds before he walks in to meet the patient. I am completely blown away by how incredibly intelligent some of the members are on their forum. I realize it isn't a medical forum but there are some members on here whose opinions or advice is better than most doctors.

100%. The "listen to your doctor" no matter what advice is very short sighted.