#echocardiography

Elle doit d'abord enfiler la jaquette exposant son torse.

La technicienne prend la pression de la patiente. Elle se situe à 119/84 à 71 battements par minutes.

Les éléctrodes sont attachées sous les clavicules gauche et droite, et une troisième au niveau de ventre.

Vue parasternale. La sonde est placée du coté gauche de son torse, environ à la hauteur du quatrième ou cinquième espace intercostal. La sonde est orientée soit vers l'axe long ou l'axe court de son coeur.

Vue apicale. La sonde est placée sous son sein gauche près de l'apex du coeur, et pointe vers les auricules.

La patiente peut voir les images de son coeur. La technicienne va évaluer l'état de ses valves, l'épaisseur du myocarde et le mouvement de ses ventricules.

Of course, seeing a cardiologist was a terrifying idea to me. The mix of excitement/arousal and anxiety/fear in these situations makes them really really difficult. After putting it off for many months, I finally somehow managed to gather up the courage and book an appointment with a cardiologist. Since it didn’t seem like a good idea to explain that some random online person had diagnosed me with MVP, I rather went to the appointment on the pretense of other concerns, such as the palpitations.

The first appointment started with a “resting” ECG, pulse ox and blood pressure from both arms, taken by a very professional and not very talkative nurse. Resting in quotes, because my heart rate was around 100, while normally it’s around 60 at rest, and my BP was something like 160/100, also very much higher than what I see at home. Then, I met the doctor. I was expecting him to auscultate me, but he didn’t do that at all - instead, he guided me to the room next doors for an echocardiogram! I’d never had an echo before, so this was pretty exciting, although the positive excitement was toned down by my fear of what he might find. The doctor had me lie down on my left side and pressed the probe to my chest, and there it was: my beating heart, projected on a big screen where I could easily see it! The doctor was very nice, and kept pointing out details to me - what valves are on the screen and so on. He also commented on how high my heart rate was at the start. Somehow, I was able to relax a little as he kept going, and then he commented on that as well, saying that clearly I’m less afraid now, because it was down to 80. I tried not to focus on his words too much, because the were really quite hot to me…

Finally, after looking at many angles and using the doppler mode as well, the doctor noted that my mitral valve seems to be prolapsing ever so slightly, which is causing a tiny bit of regurgitation. He even showed me the images where it’s visible. I feigned that I didn’t know what it meant, but inside, I was extremely relieved. It was the best possible outcome: I got the explanation for the extra sounds that I was expecting, and at the least serious grade possible. In his statement, he marked the amount of prolapse as 2 mm, when according to various sources >2 mm is the limit of what counts as prolapse. The regurgitation was also trivial, below what even counts as mild. Aside from this, everything else was perfectly fine, all measures were normal, ejection fraction was good, no structural abnormalities. I was incredibly happy to hear all this!

Even though my mitral panic was over, my cardiological adventures didn’t end quite yet. There was also the question of those palpitations, not to mention the high BP readings. This cardiologist was very thorough, and decided that the best way to get to the bottom of this was doing 24h Holter for both BP and ECG. When I went to get the devices set up, I was thinking this would be interesting and kind of exciting, but it turned out to be a complete nightmare. Taking the bus home, I was super self-conscious, because the weather was hot, and the bulky wiring was impossible to hide under a t-shirt, not to mention that the BP cuff was in plain sight. I’ve also always been concerned about having hypertension, and this became a self-fulfilling prophecy. Every time the cuff started to inflate around my arm, I freaked out. I tested a few times with my home monitor on the other arm, and the values were constantly high. At night, I couldn’t sleep, because the measurement went off every half hour. Funnily enough, the BP cuff was messing with my head so badly that I kept forgetting I also had the ECG electrodes on. They were itchy, and I would just unthinkingly start scratching at them until I remembered what they were and that I shouldn’t touch them.

The 24 hours that I had to wear the Holters felt like an absolute eternity, and I was so relieved when I could go back to the doctor’s office and get rid of that horrible BP cuff. As for the results - I was prepared to get a lecture about how my BP is too high and I have to do something about it. Really, I was trying to mentally prepare for a prescription for antihypertensive medication. Instead, the doctor - probably factoring in my explanation of how desperately uncomfortable and nervous I was this whole time - just declared that he doesn’t think I have a problem, and I could stop worrying so much. The ECG didn’t have anything too unusual in it, either. I saw the printout mentioned some PVCs, but apparently such a low amount that it wasn’t meaningful, as he didn’t even bring them up.