Please help!

I would expect a cardiologist to have carried out an echocardiogram and established your ejection fraction particularly as your symptoms are experienced when your heart is under stress.

​This would confirm that your coronary arteries are sufficiently perfusing your heart.

​Your ecg is lacking detail that would enable a proper diagnosis.

Over a year since I had an echocardiogram, long before my T waves looked like this. I do not know what the results of it was.

It looks as though some of us are, or have been assessed, as having non-specific or atypical ?results after ecg or echocardiogram. That is because indicators from just one or the other are not likely to confirm a particular diagnosis. It's not very useful to have confirmation by going for a second opinion because at the end of the day it is only an opinion.

?The ultimate test is whether or not you can live with the symptoms you've got but also to establish that, if they are worsening, you are not doing yourself harm by failing seeking medical attention.

?I presented with an ?atypical ?form of ?SVT ?on my  ecg and it took several attempts at sorting me out with echocardiograms. My ejection fraction was estimated at between 50% and 59%. It is reckoned to normally be 50% to 75% but it depends on the size and condition of your heart as to how meaningful that is.

?My view is that patients should have a record of their medical tests so that they can relate any deterioration of their symptoms to particular values. Achieving some specific average patient target is not very useful for the individuals who are unlikely to be average in the first place.

 

I had Ventricular Tachycardia, they sorted that out with an ablation, but its the Beta Blockers that they had me on for a while that seem to have destroyed my health.

Can you say what you are on now?

I am on no medication at all, not since March when I was taken off beta blockers cold turkey.

Do you smoke and/or eat much of these:

coffee, tea, cocoa, and chocolate

bananas, walnuts, avocados, fava beans, cheese, beer, and red wine.

Any foods or fluids with vanilla

Licorice

Aspirin?

Hi Bob, I gave up smoking last Boxing day. I do drink coffee, sometimes beer, very occasionally wine, cheese and occasionally bananas. I find when I cut these out it makes no difference, here is a thread I just started on the Autonomic Dysfunction forum that gives a fuller picture of mt views about my current problem . https://patient.info/forums/discuss/can-beta-blockers-cause-autonomic-dysfunction--625611

Well it looks as though you've ruled out a lot of things including the diagnosis of anxiety.

?I see you've been using an oximeter as I did to try and find out why I had really intolerable reactions to two series of treatments which I was forced (against my doctors advice) to abort.

?I monitored withdrawal reactions and was able to find some indicators of recovery using the SpO2 Assistant software which produces charts of pulse rate and SpO2 instability which are sentinel indicators of Congestive Heart Failure.

Here's my pulse oximeter results showing my SpO2 desaturation measurements after various drug withdrawals.

Thats interesting, not sure mine has that feature, plus I never tried one to compare what mine was like before Beta Blockers. Here is one of mine.

The composite SpO2 desaturation graph I uploaded was derived from several individual graphs that were produced as one of my SpO2 Assistant reporting options. It was spreadsheet based.

?However I did long recordings like yours to prove that withdrawing one of the drugs (the last one to be added to four co-administered drugs and which caused an adverse effect) was actually making things worse in terms of the blood oxygen levels and instability of both SpO2 and heart rate.

?I currently take sporadic recordings as appended to ensure that SpO2 and heart rate events are minimal. I'm quite happy with the one shown here which is after addressing my cardiac irregularities and sorted with five co-administered drugs with some effects but are tolerable.

?Your SpO2 report is a bit worse than mine that I took in 2012 when I decided I'd had enough of adverse effects.

?I've never seen a doctor so panicky when I gave him my report but he couldn't find anything wrong with the emergency ecg he took immediately afterwards.

?Your experience of beta-blocker withdrawal appears to be not unexpected but papers on the subject suggest that withdrawal in many subjects results in hyper-sensitivity to catecholamines.

Elevated T waves seemed to be linked with potassium imbalance.

?You seem however to be pretty clued up on the subject - is your doctor/s?

Unfortunately this whole experience has undermined my trust in the ability of modern doctors. I have been under investigation for my VT since 2014, the NHS could never find anything and so dismissed me, so I bought my own ECG machine.

When I showed my GP the recording of when I had symptoms, he said, that they are just harmless benign ectopics and not to worry. I have a friend however who worked in the cardiology department of St Thomas', she wanted to get a second opinion for me, next thing, I have a cardiologist ringing me at home to tell me to get an ambulance every time I get the symptoms. So much for the GP.

After my ablation last April, I am seeing another cardiologist at St Thomas who was getting angry at my notion that beta blockers could still have an effect on me after being off them for a while, he suggested I might have lung cancer in response to my declaration of breathlessness, he said there is nothing now wrong with my heart when I said I get a feeling my breath has been snatched away, however, downloading the information from the "Reveal Linq" I have in my chest revealed a massive PVC spike every time I had that feeling, he didn't apologise.

I have been trying to get somebody to look at my problems now since April, the GPs say they are waiting on the cardiologists, the cardiologists say to see my GP, even when I point this out to them, its as if they cannot hear.

The last GP visit however has made me determined to completely avoid them when a female GP said rather curtly about my eight month cough, "what do you want me to do about it?, are you worried they might find something wrong?, well you seem very anxious about your cough", a rude insinuation that I was some hypochondriac sort of person that was anxious about a non-existant illness and wasting their time. 

 

I empathise, having had very similar experiences.

? Having been treated as inpatient for a potentially fatal form of SVT on my local hospital's cardiac ward the cardiologist discharged me and asked my GP to do a blood test for hospital test on my subsequent drug response. My GP did her own test as well and suggested I cut down on the medication the consultant had prescribed. I told her that I was under orders from the cardiac centre not to deviate from the consultant's prescription as it would prejudice the subsequent cardioversion.

She said as I left the room - I suppose they know what they're doing!

?Subsequently it turned out there was almost a complete breakdown in communication between the medical practitioners dealing with my treatment.

?I also started doing my own ecgs and even did a cardiac spectrogram of my heart valve function - attached.

Goodness!, how did you do that!, that would really freak out my doctors who already get flustered when I come up with specialist terms they didnt learn when becoming GPs.

Hi Peter,

?I used a Fetal Doppler with a 2 MHz  probe which can penetrate tissue more deeply than superficial probes. I then positioned it between ribs on my chest directly over the location of the four heart valves.

?I then recorded the audio spectrum sound onto my PC via the earphone socket and selected exactly one heartbeat on the music application called Wavelab LE.  Then I chose the 3D Frequency Analysis option which generated the coloured three dimensional image showing both time domain on left and frequency domain on the right.

?To further clarify the interpretation of this image I superimposed the Wavelab captured Fetal Doppler waveform on the 3D image with an image processing app and annotated this heartbeat waveform with the heart sounds (that at least heart specialists should know about) - s1 though s4. Funnily enough s4 is the first and s1 and s2 are further divided.  

?With a bit of study I managed to link s1 though s4 to specific heart valve opening and closure times.

?I did all this at the time after hospital treatment for SVT and when I was deemed to be in sinus rhythm.

?Although I was (and still am)  on a carefully selected range of five drugs I felt remarkably well considering, so this 3D image is really a baseline representation of what it should look like when I'm OK.

?I'm currently using:

CONTEC CMS50D+ with SpO2 Assistant s/w

Heal Force PC-80D Advanced Handheld ECG Monitor Portable LCD Electrocardiogram Heart Monitor

?with analysis s/w.

?Beurer blood pressure monitor BC58 with irregular heart rhythm indicator and analysis s/w to derive Mean Arterial Blood Pressure.

?Regards

?Bob

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