How things work?

[jajrussel]

not exactly sure where to post this Question
I am confused at the results of an echocardiogram  the initial  reading was enough to convince that there was a possible blockage which there was. They installed stents. A month later they do another echo yet the reading is essentially the same? How does that work? The heart  ejection fraction apparently presents the same in both readings so essentially the before and after Picture present the same   Physically  I know the new plumbing is working. I am fairly certain that the meds I am taking are not designed to create a simple  physical feeling of wellness yet the EF in the second test matches  the EF in the first test  scientifically how i is that possible?  Do they move the goalposts and why would they?

Edited December 18, 2019 by jajrussel
I am not taking the blame for something my phone keeps doing any more 😡

[Phi for All]

Can I assume your EF was below 50% when they suggested installing stents? And if it's still below 50%, don't they still have work to do? Your left ventricle should be pumping out 50-75% of the blood in it every beat. If it's already at 50% or better, I'm not sure it's a problem.

This is the PERFECT question to ask your cardiologist. They know the most about all the factors affecting you specifically, and they actually love explaining processes to people with a little science knowledge.

[jajrussel]

1 hour ago, Phi for All said:

Can I assume your EF was below 50% when they suggested installing stents?

Then it gets confusing, the latest echo shows the same.presumably the meds and rehab will eventually in the next 90 days raise it above 50% or I am to get an implanted defibrillator

 

1 hour ago, Phi for All said:

This is the PERFECT question to ask your cardiologist. They know the most about all the factors affecting you specifically, and they actually love explaining processes to people with a little science knowledge.

The window of opportunity is small. I'm guessing that my question was confusing to the cardiologist. I sensed confusion when I asked. I realize that senses are are a poor indicator of reality maybe he needed time to think about it.  The whole process was confusing and still is, but I am reluctant to let them to implant a device the size I of a small cell phone when the explanation is that basically it is designed to simply jumpstart the heart apparently I have 90 days to accept the need if the echo doesn't improve so I was wondering about echo grams? How they work and why after New plumbing is installed the reading would be the same. When I have asked all I have gotten is a look of confusion.  Anyway thanks... I'll l ask him again and probably again until I have to make a decision. Thank you.

Edited December 18, 2019 by jajrussel

[Phi for All]

1 minute ago, jajrussel said:

apparently I have 90 days to accept the need it the echo doesn't improve so I was wondering about echo grams? How they work and why after New plumbing is installed the reading would be the same. When I have asked all I have gotten is a look of confusion.  Anyway thanks...

I'm not sure why you're getting the confusion, it seems like a perfectly legitimate question. This tells me there is something else at work possibly. 

Perhaps you should rethink the way you're approaching your doctor on this. Tell them it was your understanding that the stents would increase the fraction of blood pumped by your heart each beat, but the ECG results don't seem to show that. I'm wondering if their head-scratching means you've interpreted something wrong, or you're looking at the wrong readings. 

[MigL]

They don't usually put stents on the major arteries coming out of the Lventricle as they are more prone to aneurysms than blockages.
They usually put stents in the much smaller arteries supplying the heart itself with blood.
That is the case for everyone I know that's had stents put in; so I don't see what EV has to do with it.

Your heart specialist is the best person to have this conversation with

[jajrussel]

33 minutes ago, Phi for All said:

I'm not sure why you're getting the confusion, it seems like a perfectly legitimate question. This tells me there is something else at work possibly. 

Perhaps you should rethink the way you're approaching your doctor on this. Tell them it was your understanding that the stents would increase the fraction of blood pumped by your heart each beat, but the ECG results don't seem to show that. I'm wondering if their head-scratching means you've interpreted something wrong, or you're looking at the wrong readings. 

With the new setup they have  I generally see the reports before they do maybe the confusion comes at the question in the first place, if he  wasn’t expecting me to ask it? it’s pretty much straight forward in what it says Nothing to interpret. I will ask him again and go over it line by line if needed , and you got it right away, what I was expecting from the stents and I do feel remarkably better.the reading just doesn’t match thee way I feel now, or it was initially much worse and the initial number would have been lower than the stated 30-50% and the reading that now presents would be capable without me feeling any pain initially. I’m thinking I had the wrong conversation with the surgeons who put the stents in they probably had a better view than I and didn’t really need me telling them where the end of the Catheter was  in play by play. It’s just that when they got to the part where the pain wa I seemed important to tell them yes that the place exactly. I’ll write it down for him. Maybe he wasn’t expecting me to have any information since that part of the system is fairly new here ,and now I am just making conversation. So thank you once again.

3 minutes ago, MigL said:

They don't usually put stents on the major arteries coming out of the Lventricle as they are more prone to aneurysms than blockages.
They usually put stents in the much smaller arteries supplying the heart itself with blood.
That is the case for everyone I know that's had stents put in; so I don't see what EV has to do with it.

Your heart specialist is the best person to have this conversation with

I’m new to this language so was EV a typo? You didn’t mean EF?  The window for talk is tiny. The New app that connects the patient to their Reports has an ask questions feature not sure how it works, but I’m gonna give it a try.

the order of events is difficult to remember but I’m pretty sure someone told me they were shipping me up to another hospital because the EF was less than , or between 30 and fifty percent and they could test and repair at the same time. Maybe that is where I got the impression that the EF was an important indicator. Now if it has little to do with it , it changes everything . The indication changes because  I was wondering why they would want to jump start a car with a clogged fuel line? So, to speak.

Thank you both

[MigL]

Sorry, the EF.

What usually happens is that the blood vessels supplying the heart get blocked. This leads to the heart having to work harder with a more limited supply of blood. And this can lead to heart attacks and/or reduced heart function.
The reduced heart function would show up as lower EF.
If the heart has been damaged, this reduced function could be permanent, IE sections of the heart are 'dead' and can't function properly anymore. The stents will not improve EF, but will keep it from getting worse.

Your symptoms were probably shortness of breath because of fluid build-up in the lungs, chest pains, and if really bad blockage, numbness and cold sweat, IE you're having a heart attack !

I'm sure you talked to a specialist before the procedure was performed.
Make a follow up appointment; he/she is the one you should be consulting with.

[jajrussel]

4 minutes ago, MigL said:

Sorry, the EF.

What usually happens is that the blood vessels supplying the heart get blocked. This leads to the heart having to work harder with a more limited supply of blood. And this can lead to heart attacks and/or reduced heart function.
The reduced heart function would show up as lower EF.
If the heart has been damaged, this reduced function could be permanent, IE sections of the heart are 'dead' and can't function properly anymore. The stents will not improve EF, but will keep it from getting worse.

Your symptoms were probably shortness of breath because of fluid build-up in the lungs, chest pains, and if really bad blockage, numbness and cold sweat, IE you're having a heart attack !

I'm sure you talked to a specialist before the procedure was performed.
Make a follow up appointment; he/she is the one you should be consulting with.

Thanks much clearer. Described  as accurately as I remember it on Halloween night while passing out candy. He/we agreed to wait.  90 days  for the meds and rehab to work then test again then decide if I want what looks like. Cell phone implanted. I haven’t had a lot of luck with cell phones which do not seem designed to last even as long as the ride home   The doc is going to be the final say if the insurance doesn’t stop the process. Again thanks

[MigL]

That 'cell phone' is actually a defibrillator.
I have a friend who had a quadruple bypass at age 52.
Some parts of his heart are damaged, and have not recuperated, so on occasions when his heartbeat becomes irregular, the defibrillator gives it a jolt to reset his heart. It also stores/transmits this information to your doctor so he/she can decide if medical intervention is necessary.

If not needed, and you never have episodes where a defibrillation is necessary, they can be removed.
Go with your doctor on this. For your own health and safety.

[jajrussel]

Thank you