What to do with inconsistent data

[FredW]

Hi folks,

It seams like the more I learn, the more I wonder. I wonder if any of you have had experiences with test results being inconsistent and how you deal with it. I just had a catheterization test done because my last echo tests indicated I was approaching the serious stage of aortic stenosis. The cat test results shows my stenosis has NOT progress to the serious stage. I guess this would be good news had I not received such inconsistent data.

The Cat. doctor told me before the test was performed that he didn't expect the results to show anything different than the echo tests. The echo tests had the valve area at .8, then when the cat showed it to be a 1.4, I asked why such a difference. His answer was that often echo tests can be wrong if the technician does not position the prob correctly. He also told me that my stenosis is not the cause of my symptoms - that I should go back to my GP to determine the cause. In the last 18 months, I have had three echo tests showing the valve area go from 1.3 to 1.0, to .8 and have a hard time believing that three tests were wrong.

Also, I found that the local cardiologist I have been seeing who ordered the cat test told me the criteria for surgery is when the valve area is at .8 or less. The cat doctor told me that they use three metrics to determine when surgery should be done: the valve area, the gradient, that the EF (heart pump he called it). Also, I found out that the local cardiologist specializes in cardiac Electrophysiology, which is pacemakers and other devices. I was asked why I was not seeing a regular cardiologist. I didn't have an answer for that.[FONT=Verdana, Lucida, Geneva, Helvetica, Arial, sans-serif] [/FONT]

So, if I believe the cat test results, surgery is not near. However, having an mathematical mind and engineering background, getting inconsistent answers and data troubles me. Also, I am now wondering if I am imaging my symptoms or is there something else causing them or is the stenosis causing it and the data is just inconsistent.

I will be asking my GP, who I trust more than any of the cardiologist I have seen, to advise me as to what I should do: seek another cardiologist, wait more, or do more tests?

Have any of you encountered such variation of tests results.

Confused and wondering.

 

[carolinemc]

Well, hate to burst your bubble, but your GP will not be too helpful about cardio issues, you need a cardio for that and you need to get another cardio and tech. Your GP can recommend a cardio to you. You have to be with a cardio with the heart issues. Is your GP an Ostopathic Doctor by chance? Otherwise it is better to have a cardio checking the heart issues. Most techs try to read the results without knowing what it is they are reading for heart patients. Good luck if you search for another cardio, make it a cardio-vascular doctor, they know everything in heart issues. Good luck and hugs for today.

 

[Paleowoman]

Well I hope your GP can help Fred. I had a very good GP who was able to give me good advice and who understood a lot about cardio matters and was always very helpful when I was coming up to surgery and after. I suspect it depends on individual GPs as some, like mine, are excellent at particular aspects of healthcare while others may not be. Hopefuly your GP will be able to refer you to another cardiologist for a second opinion. My cardiologists - I had one and then moved to another - both appeared to go on valve area size, pressure gradient and ejection fraction, plus of course symptoms. But a person can have symptoms which appear to be cardio related but which are not (I've had that) and that requires a good doctor to discover too.

 

[Texanbarbie]

Hi Fred ! I can certainly relate to your concerns on the discrepancies. Not only has my last three echo data been all over the place as far as my aortic valve opening, but the numbers on my ascending aortic aneurysm have been up and down as well. I wasn't overly concerned until I started having symptoms a few months ago such as shortness of breath, dizziness and cough. I compiled the last 3 echo data onto a spreadsheet and was shocked at how things seemed to be going downhill in just the last year. When I saw my cardiologist in November, he explained some of the numbers and reassured me that I was doing just fine and my symptoms were in no way related to my heart. When I asked about the discrepancies between echoes, he told me a lot depends on the machine AND the technologist who performs the echo. So from now on I will request the same technologist ! As far as my aneurysm, I'll have to start going to a better facility and stick with that one to perform the MRA. One other piece of information my cardiologist gave me with regards to the echos - - he said the most important numbers to be concerned about are the Aortic Valve Gradients, the AI PHT which indicates leakage and should be below 200 and the Tricuspid RVSP which should be above 40. If you have a GP that you trust, I would definitely ask him for a referral for a cardiologist. My cardiologist is an Intervention Cardiologist, but I live in a small town and there aren't many choices. Keep us updated !

 

[FredW]

Thanks Texanbarbie for sharing your story. I did see another cardiologist today - in Pittsburgh and highly recommended. He looked over all the previous tests and did a stress test today. He thinks I may have a bicuspid valve (one of the earlier echo tests suspected that, but a follow up TEE test did not show it). Based on what he saw today, he says I am not ready for surgery and that I'm in the moderate/serious category.

He put me on a beta blocker to slow down my heart and to lower my blood pressure (it is borderline high and I have been taking medication for it for over a year). He is also going to see if the insurance company will approve a cat scan of the heart.

I will do a follow up with him in three months and fire my local cardiologist. She is just too inexperienced for me to accept. After all it is MY heart we are talking about and I don't fee comfortable letting her train on me.

I will post an update when I finally get this sorted out. The Pittsburgh doc did confirm my test results were all over the place, so it confirms what Texanbarbie also saw. The bottom line is that if you are not comfortable with your Doc, find another.