Failed medical

davidof

I failed my medical for a cycle event I wanted to enter. Doctor was about to write me a certificate but decided to do an ECG at the last minute. The computer flagged up an "enlarged left ventricle".

I now have to see a heart specialist in a month. I think my blood pressure is ok, 107/67, 54bpm on the ecg. However it is my age which stops me getting the green light (49).

ugo.santalucia

Enlarged left ventricle can be a condition, my dad had it and had to take medications... so don't underestimate it and get all the tests done

BenderRodriguez

Probably just 'Athlete's heart syndrome'. (Enlargement due to exercise.)

This does normally affect the left ventricle, but they will want to see if the enlargement has any other cause, such as a failing valve.

Ah, I see you are in France! They are very hot on this sort of thing there. Just get the MRI done, you will probably only have to wait a couple of weeks.

Don't worry!

davidof

Yes I'm going to get the tests done and see what they say.

FatTed

I doubt your tests would include an MRI.

BenderRodriguez

FatTed wrote:

I doubt your tests would include an MRI.

I had much the same issue earlier this year, although my cardiologist, via ultrasound, found that that in my case the right ventricle was also enlarged, and disproportionately so. A week later the definitive diagnosis was done by means of an MRI scan. Conclusion? Nothing wrong with my heart, other than it seems to develop in respond to exercise in a slightly unusual way.

I also live in France but I would bet that even the NHS would follow a similar diagnostic path.

By the way, I only visited my cardiologist because a long term problem I have had with tachycardia was getting worse. The day after my MRI they investigated this and found a 'short circuit' that, unfortunately, was very close to the central controlling node of my heart, and so was going to be difficult / risky to treat with ablation. However, I didn't respond well to verapamil so I decided to take the risk and two weeks later I was admitted for an ablation. No problems since. I hope things stay that way!

davidof

Yes it will be an ultrasound test initially. It is a bit stressful waiting a whole month before this is done but I guess that is pretty quick in the global scheme of things. Wait and see, I guess.

Brommers76

They wouldn't normally do an MRI, ECG then echo most likely.

BenderRodriguez

Brommers76 wrote:

They wouldn't normally do an MRI, ECG then echo most likely.

The only reasons I can think of for not doing an MRI are cost and having access to the facilities. An MRI scan gives a far more detailed view and when I visited my cardio I got the impression it was the 'method of choice'. The final scans are pretty impressive, being taken from a number of 'viewpoints' and allowing the functioning of the heart and its valves to be run in 'real time'. I was given the CD with the images and necessary software and was even able to view them on my own computer!

Here is a BBC story on the topic:

Magnetic resonance imaging (MRI) scans should be used to assess patients with suspected heart disease, rather than standard checks, experts say.

A University of Leeds study of 750 people found MRI was better at detecting the condition, and of ruling it out in unaffected patients.

http://www.bbc.co.uk/news/health-16305278

Note the final paragraph:

in a commentary in the Lancet, Dr Robert Bonow of Northwestern University in Chicago, said the improved accuracy of MRI "must be balanced against availability and cost-effectiveness".

Don't forget that the OP lives in France (as I do), so perhaps the way the 'cost effectiveness' is calculated here is somewhat different to the UK, where a greater priority seems to be placed on paying high salaries to 'managers' and siphoning off public funds into the profits of private companies via outsourcing, PFI scams and so forth!

BenderRodriguez

Another article on the benefits of cardiac MRI:

MRI can be used to calculate ejection fraction, left ventricular function, and to assess wall motion more accurately and reproducibly than echocardiography. Stroke volume, end-diastolic and end-systolic volumes, cardiac output, and left ventricular mass and wall thickness can be readily measured. Valvular assessment for regurgitation can be performed using cine multi-phase techniques. The regurgitant fraction of a "leaky valve" can be calculated, and valve disease progression accurately assessed, over serial exams. Valvular stenosis can be evaluated, flow velocity can be measured through a stenotic valve, and valve area can be calculated, using phase-contrast quantitative flow techniques...

http://www.tristans.com/hf_mri/clinapp.php