Thoughts on mayo clinic and stress test?

[Davsey27]

I was curious I recently saw a cardiologist who did a 24 hr holter and found several premature ventricular contractions (2700) and roughly the same amount of prematurely atrial contractions
Occasional SVT

It also said in my medical records IVCD(intraventricular conduction delay)
Mitral/triscupid/pulmonary[trace] regurgitation
S4 gallop

The second opinion cardiologist I saw who did a 30 second ekg said he didn't see an s4 gallop

He reviewed the 24 h holter from the other cardiologist I saw as well as the echo and the 2day cpet from 3 years ago

Mild right ventricular hypertrophy on the echo otherwise normal.But the med records say Left ventricle hypertrophy which seems contradictory to the doctors notes

Left ventricle Ejection fraction was 59%
Stroke volume around 60% on the lower end of the normal range

The followup with nurse practioner suggested magnesium and Omega 3.I sought another cardiologists opinion.He said echo is normal although

He suggested have some kind of rare mitochondrial conditon with the 2 day Cpet for disabiliy that i did with workwell foundation...

After the test it took me 6 months to return to my baseline functioning of 30-40%

And that it is unknown if it's just heart or systemic.That even if heart was treated it may not fix the problem.He suggested there is little evidence for treatments for a rare mitochondrial disease

He asked if I ever got a virus.I said yes ebv


He said he's more concerned about underlying mitochondrial problems then the arrythmias and asked me if I ever tried an energy drink

He says at rest during echo heart may appear normal but ejection fraction with exertion may be heart failure

I don't seem to have any fluid buildup.He also mentioned something about cardiomyopathy and that the heart failure screening may suggest transplant


He gave me a referral to the mayo clinic.Early today I got a call from a lady at mayo after scheduling an appointment and they mentioned were calling on a recorded line and the cardiologist at mayo in phx would like to do an exercise test

I mentioned to the that I have already done one and will provide records [it was done about 3 Yeats ago]

I am concerned about the Pem from an exercise test as that last 2 day cpet crashed me badly and lowered baseline for 6 months

Without even meeting a patient and ordering an exercise test is this a red flag from Mayo or the doctor?

Wondering if the mayo doctors can get too some of the root cause(s) or if is a waste of money as I qualify for medicare but not medicaid

If there is a root mitochondrial disease/cardiomyopathy or something bizarre that isn't showing up on echo

Thank You

 

[lenora]

I can't/won't tell you what to do, but I have had a mild heart attack myself (age 76, female). I had a chemical stress test and since my husband's cardiologist was retiring, I suggested that he go to my new one.

Apparently the chemical stress test is now the preferred method. My husband had no problem with it, and I was in a coma at the time mine was done.

Why hasn't another Holter Monitor been done? In heart patients these are done at least every 2 yrs. They aren't as cumbersome as in years past.

I have 7 stents, and will be getting more. My husband had a cardiac arrest about 20 years ago. One generally doesn't survive them....but I managed to get him to the hospital even though he had another arrest on the way and one in the ER. He seems to be fine now. He's very active.

I would stay on top of this.....see what the Holter shows and then go from there.

I'm sorry, but I don't know anything about what Medicaid covers apart from nursing care (for meds) and household help, if you need it. Better health. Yours, Lenora

 

[Mary]

I am concerned about the Pem from an exercise test as that last 2 day cpet crashed me badly and lowered baseline for 6 months

@Davsey27 - an exercise stress test generally is only done once - on one day. The 2-day cpet is different - it's done on 2 consecutive days. So I'm assuming you would tolerate the one-day test better than the 2-day CPET. For me, PEM always hits on the 2nd day, and if I had to do a test on the second day, such as with the 2-day cpet, it would be a lot rougher.

However, you very well could have trouble with just a 1-day exercise stress test. There is a chemical stress test which can be done in place of the physical exercise stress test if someone has trouble doing the exercise stress test, so you can ask about the chemical test. Since your 2-day cpet was done about 3 years ago, I'm guessing it's normal for the doctor to ask for a new test. But I'd talk to them about this as well and ask if your old results would be helpful. And you might be able to do the chemical stress test and tolerate it better than the exercise test.

I had the chemical stress test done some 10 years ago? I can't remember how long ago, but it didn't cause PEM for me.

 

[Davsey27]

@Davsey27 - an exercise stress test generally is only done once - on one day. The 2-day cpet is different - it's done on 2 consecutive days. So I'm assuming you would tolerate the one-day test better than the 2-day CPET. For me, PEM always hits on the 2nd day, and if I had to do a test on the second day, such as with the 2-day cpet, it would be a lot rougher.

However, you very well could have trouble with just a 1-day exercise stress test. There is a chemical stress test which can be done in place of the physical exercise stress test if someone has trouble doing the exercise stress test, so you can ask about the chemical test. Since your 2-day cpet was done about 3 years ago, I'm guessing it's normal for the doctor to ask for a new test. But I'd talk to them about this as well and ask if your old results would be helpful. And you might be able to do the chemical stress test and tolerate it better than the exercise test.

I had the chemical stress test done some 10 years ago? I can't remember how long ago, but it didn't cause PEM for me.

The Cardiologist at Mayo suggested he is not familar with CPET that was done 2years ago

Lvef fraction was 59% in echo

He said uncommon but not impossible to have right side failure but need stress echo

I have disability review in a year and concerned that if the stress echo was normal

It may negatively effect the disability review


Also concerned about Pem


On the other hand,if there is something significant detected in stress echo[cardiomyopathy,exertional failure] then I worry I would have missed out

Im about 30-40% functioning on the CFS scale

Thank you