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connie Find out more about connie
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  • Gradient Question

    Hi All,

    I pop in and out from time to time, reading mostly. I had a quick question or two.
    I went to see a new cardiologist, in B-ham Alabama a couple of weeks ago, actually he wasent new to me, he helped Dr Neilsen @ MUSC perform my Ablation, Jan/2003, while he was on fellowship whith him.

    At any rate I decided to use him as my regular cardiologist. He did and ultrasound and when they measured my gradients, the one @ rest was 11 and the one during Val Salva, 45.

    My question is do the gradients go up and down at different times. When I had my check up @ MUSC this past March, the gradient, W/ Val Salva was 128.

    Thats a big difference to my way of thinking.

    They are wanting also to schedule me a clinical series of test for the elctrical workings of the heart.........I cant spell the big giant word they called it and the doctor they want me to see. ELECTRO somthing.
    Anybody with any ideas on this?

    Connie
    The BEST is yet to come !!

  • #2
    Re: Gradient Question

    1. Yes, gradients can vary alot depending primarily on your level of hydration, but also if you are tired, time of the month for women, and many other factors.

    2. What they are probably looking to do is an electrophysiology study or EP study for short. I think you should ask more questions about whey they want to do this to you. In some non HCM patients these are used to assess need for an ICD, but for HCM patients, they aren't really helpful as a negative EP study isn't really meaningful in ruling out the possibility of sudden death. Are you having problems with arrythmias? Are they looking to do a catheter ablation to cure an arrythmia? These aren't done on HCMers so much either as there are usually too many pathways to ablate.

    I would be very reluctant to undergo an EP study unless someone gave me a really good reason.

    Good luck. As alot more questions.
    Daughter of Father with HCM
    Diagnosed with HCM 1999.
    Full term pregnancy - Son born 11/01
    ICD implanted 2/03; generator replaced 2/2005 and 2/2012
    Myectomy 8/11/06 - Joe Dearani - Mayo Clinic.

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    • #3
      Re: Gradient Question

      Thanks Cynaburst for the quick reply....

      I have a real problem with PVC's on a regular basis, and I have episodes of the NEAR passing out, never have, but once in a while I have what I refer to as the BLACK spells.
      That info, coupled with the fact my mother died suddenly @59 is his reasoning for wanting the study done, to see if I may be a canidate for an ICD.
      Dr. Neilsen @ MUSC dident feel I needed an ICD just yet.

      I personally am not excited at all about this STUDY and am leaning to not having it done. My husband suggested I wait and talk to Dr. Neilsen about it when I see him for my 2nd year check up in January 2005.

      Thanks
      Connie
      The BEST is yet to come !!

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      • #4
        Re: Gradient Question

        Connie, like Cynaburst said, the EP study isn't very helpful in determining your risk for sudden death in an HCM patient. Your heart is just too different. Get the second opinion.

        Reenie
        Reenie

        ****************
        Husband has HCM.
        3 kids - ages 23, 21, & 19. All presently clear of HCM.

        Comment


        • #5
          Re: Gradient Question

          Connie, I too have problems with PVC's. Also, for almost a year I have been having these near fainting spells as well. My Dr's can't agree on what is causing the spells, and my cardio isn't at all concerned about the amount of PVC's or how much they effect me. I understand how very frustrating it is and hopefully you can soon get some answers. I have never had the opportunity to have an EP study done so can't help you there.

          Take care
          Pam
          It's not what you gather, but what you scatter that tells what kind of life you have lived.

          Dx in Feb/99. Obstructed. No ICD, no surgeries, no family history. 2 sons ages 14 and 6.

          Comment


          • #6
            Re: Gradient Question

            Hi Pam........

            My G/P doctor was always very nervous about my PVC's and "black spells" and kept encouraging to get an ICD, but my Cardio Doc @ MUSC does'nt seem to think I need one, go figure.

            He keeps a close eye on the situation and I feel secure w/ his recomendation.
            Those Little Devils (pvc's) sure are scary feeling sometime. Do some of your leave you breathless @ times?

            Thanks

            Connie
            The BEST is yet to come !!

            Comment


            • #7
              Re: Gradient Question

              Connie - can you call the office - I think we need to chat a bit.

              Having a gradient post ablation is not a good thing - the goal is to get rid of the gradient all together.

              I will be in the office in the morning.

              Lisa
              Knowledge is power ... Stay informed!
              YOU can make a difference - all you have to do is try!

              Dx age 12 current age 46 and counting!
              lost: 5 family members to HCM (SCD, Stroke, CHF)
              Others diagnosed living with HCM (or gene +) include - daughter, niece, nephew, cousin, sister and many many friends!
              Therapy - ICD (implanted 97, 01, 04 and 11, medication
              Currently not obstructed
              Complications - unnecessary pacemaker and stroke (unrelated to each other)

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              • #8
                Re: Gradient Question

                Originally posted by connie

                My G/P doctor was always very nervous about my PVC's and "black spells" and kept encouraging to get an ICD, but my Cardio Doc @ MUSC does'nt seem to think I need one, go figure.

                He keeps a close eye on the situation and I feel secure w/ his recomendation.
                Hi Connie. I'd be very nervous too. Good luck.

                Reenie
                Reenie

                ****************
                Husband has HCM.
                3 kids - ages 23, 21, & 19. All presently clear of HCM.

                Comment


                • #9
                  Re: Gradient Question

                  Hi Reenie,

                  Thanks for the advise.I saw my G/P day before yesterday, just to tell her good bye, as she is moving to north Ala.

                  She told me she had gotten a note from Dr Cauthan where is is scheduling me a EP study, and I told her I wasent going to have it done and she ask me if I wanted to drop dead? ha ha
                  I invited her to my funeral, (i have a strange sense of humor and she is good natured), and she diclined as I am being "BULL HEADED" as she puts it.
                  I explained to her about waiting to see Dr Neilsen @ MUSC in Jan. 2005.

                  Im going to talk to Lisa this next Tues. Maybe she can give me some insight on what I need to do.
                  Im like "Scarlett" now....tomorrow is another day..I cant think about this right now....ha ha its FRIDAY!!!

                  Connie
                  The BEST is yet to come !!

                  Comment


                  • #10
                    Re: Gradient Question

                    I wish you the best of luck. I know it's a pain to wait, but sometimes it's best. Have a great weekend.

                    Reenie
                    Reenie

                    ****************
                    Husband has HCM.
                    3 kids - ages 23, 21, & 19. All presently clear of HCM.

                    Comment

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