Cardiologist appointment tomorrow.

[the reach]

I'm scared stiff. They noticed a tachycardia on my sleep study back in December. My GP and the sleep specialist said not to worry, these things happen all the time and don't necessarily mean anything. But to be sure my GP sent me for a echocardiogram and a heart stress test. No issues with the former but the heart stress test showed a possible issue. My GP's office got the results about a week or two later and called me 3 times in one day for me to come in the next day for that result. The GP, while telling me it is still likely nothing, wrote urgent all over my referral and didn't wait for the holter test (which isn't scheduled until the end of this month) and given that the cardiologist didn't wait for that result either, I'm panicking. There was no rush until the stress test results and now there is lots of rushing.

I've been reading about the connection between sleep apnea and heart disease and not liking what I am seeing.

I've been trying to think of useful questions for tomorrow and have had some success but my sleep apnea brain doesn't really want to concentrate right now. Hopefully, I will not forget my list of questions.

So far:
1. explain apnea connection
2. what exactly did the heart stress test say, how determinative is it?
3. exercise - any limitations
4. what do I need to watch for
5. next steps?

If any one else has been through this, I'd love any advice, success stories, other questions, reassurance that you might have to offer.

-Adrienne

[idamtnboy]

I'm scared stiff.

That is perfectly understandable, and dare I say, you have a right to be.

I've been reading about the connection between sleep apnea and heart disease and not liking what I am seeing.

Check out these two sites. http://www.mayoclinic.org/tachycardia/causes.html
http://www.mayoclinic.org/tachycardia/causes.html

It looks like there are quite a few causes for tachycardia (rapid heart rate) so in your case sleep apnea may or may not be it.

I've been trying to think of useful questions for tomorrow and have had some success but my sleep apnea brain doesn't really want to concentrate right now. Hopefully, I will not forget my list of questions.

So far:
1. explain apnea connection
2. what exactly did the heart stress test say, how determinative is it?

If the echocardiogram was clear then blockages in your heart arteries probably are not a problem. I'm not sure, based on my three experiences, that the stress test by itself really says much of anything. The problems are uncovered by the other diagnostic tools that see the issues when the heart is made to work hard by the stress test. That's why the echocardiogram. I've had that twice, after a procedure to install a stent and do two angioplasties. The procedure was determined to be needed based on the results of a nuclear stress test, where a radioactive dye was tracked through my heart before and after a walk on the treadmill. In all three cases all the treadmill part of the test did was get my heart worked up to 150% of normal rate.

3. exercise - any limitations
4. what do I need to watch for
5. next steps?

If any one else has been through this, I'd love any advice, success stories, other questions, reassurance that you might have to offer.

-Adrienne

Don't be too concerned about remembering all your questions. If the cardio is good, he/she will do a information dump on you. In my untrained opinion, the simple fact you have a heart rate problem indicates something is fishy somewhere. You are just starting on an unsettling trip. Plan on learning about problems, but if your GP downplayed things somewhat, I wouldn't stew over the unlikely probability of major heart surgery. I don't want to frighten you, but I do want you to approach this with the realization that there most likely are some sort of real problems, problems that can be overcome and mitigated by medical procedures and lifestyle changes. Prepare for the worst, and hope for the best. That way you will not be disappointed regardless of what you learn tomorrow.
God Bless.

[Otter]

I suppose the reason for the rush could be that your cardiologist is thinking, "OH MY GOD!!! SHE'LL BE DEAD IN FOUR DAYS!!!!!"

But it's more likely that the reason for the rush is that most heart disease is treatable if you start in time. Hearts and very hardworking organs, and they need plenty of oxygen and nutrients from the blood they pump. But once a heart looses some of its muscle, not only does the remaining muscle have to work harder, it doesn't get fed as well because it isn't moving the blood to the lungs and digestive tract and back as quickly as it used to. Past a certain point, heart damage causes more heart damage, and your health begins a slide that is very difficult to stop. The more damage a heart takes before treatment begins, the less they'll be able to do.

[Breathe now comes the reassuring part.]

So having seen indications that something may be amiss, your cardiologist is moving ahead with the diagnostics quickly so that if there is something wrong, you can start treatment before whatever it is pushes you onto the downward slope. This doesn't necessarily mean that you're in deep trouble. What it does mean is that your cardiologist isn't taking any chances on your health deteriorating while he tries to break 80 on the golf course. That is a good thing. Because this is all driven by testing rather than overt symptoms, odds are that the rush is to nip a problem in the bud. Be glad something showed up in the sleep study to start the diagnostic ball rolling before things got out of hand. Most people learn about their heart trouble in the ER, and the outlook isn't as good for them as it is for people whose heart disease was caught by tests before things got ugly. Early detection is the key to effective treatment, and it sounds like that's exactly what's happening. In other words, you are one of the lucky ones.

[the reach]

Thanks to both of you. You were very reassuring. The cardiologist, unfortunately had no answers. Mainly because she needs two more tests before she is sure of anything. Fortunately, she believes that the stress test was likely a false positive (because I am a woman and apparently 30% the results are false positives for us and I have relatively few other indicators). However, she certainly was convinced of the need for a CPAP machine to make sure that my blood pressure STAYS good. I knew that apneas can cause spikes in BP overnight but apparently over the long term they cause elevated BP all the time.

[xenablue]

Hi Adrienne,

You are actually in a fortunate position - that an irregularity has been discovered BEFORE something worse could happen to you. This means that treating whatever is wrong with you will reduce or eliminate any possible scarring from a heart attack etc.

I can understand how scared you are, but you obviously have a good medical team working to make sure you avoid having any major problems. That you got through a stress test without the techs having to stop due to something serious showing up is a good sign.

I had a heart attack in 2004 and fortunately it was reasonably mild, but I had angioplasty and a stent and until last year, had to endure a stress test annually.

I am also diabetic and the reason I had a sleep study 6 months ago was to see if OSA was the cause of my high fasting glucose numbers as ever other cause had been eliminated.

Cheers,
xena

[jimnsc]

My cardiologist referred me for the sleep study due to my experiencing three episodes (months apart) of Atrial Fibrillation (heart goes out of normal sinus rhythm and tends to flutter rather than have good, solid beats). The thinking behind the referral was that if I had sleep apnea it was likely the cause for my heart going into A. Fib. Fix the OSA - no more A. Fib. - WE HOPE!

In your case my friend, if the news was bad news, they'd likely have explained it to you in the emergency room - not the way things are happening for you presently. Keep your chin up. They won't fool around if it's your heart.

Jim