Hi, Iam just wondering how long and how hard for a diagnosis?

Posted by lucy4 @lucy4, Mar 26 7:03pm

Hello.
My name is Lisa, I live in Ontario Canada. Iam 48. I have a paternal grandfather who had HCM and died at 48 (just dropped on a sidewalk), I also have a father who has HCM and A Fib. About 7 yrs ago I started having chest tightness, sob and pounding heart (it almost hurt) at the time I didn't know my paternal grandfather had it as well. Dr sent me for an echo, showed a mid cavity gradient of 29mmhg with Valsalva (1 below diagnosis threshold), rwt .47, EF 67.1-75% as well as a small left ventricle size and daggers and turbulence on the echo images. I did not see a dr after that one bc I was told it was normal. I had another echo this week due to same symptoms and some new ones (dizziness when standing, squatting, bending, lifting, rolling over). This echo was completely different, I did Valsalva many times and it was not mentioned in the report at all,as well as rwt was at .33, EF was low. ....someone told me laying on my left side almost the whole time will make it not appear as it is (possible mid cavity obstructive hyper dynamic hypertrophic cardiomyopathy)and the report said image quality was poor...so with these 2 echos being "normal" I'm not likely to get a referral to the HCM specialist nearby. Just wondering if it's normal to get such contrasting echos and getting someone to actually listen and take it a little more seriously? Side note, my maternal great grandmother also dropped dead of a massive heart attack in her early/mid 50s .

Thank you!

Interested in more discussions like this? Go to the Hypertrophic Cardiomyopathy (HCM) Support Group.

Profile picture for Linda, Volunteer Mentor @walkinggirl

@pamela47 Greetings to our fellow big hearted people Down Under! Many cardiologists are unfamiliar with HCM in the states, too. In the cardiology office where I am a patient, different cardiologists specialize in different aspects of heart disease, I was fortunate to be assigned to one very knowledgeable about HCM at my first visit. I do not know if more men than women have HCM, beecause it's not linked to the x or y gene, only that the chances are 50% if a parent has it. Now, what can you do to help educate people - and doctors - about HCM? The Hypertrophic Cardiomyopathy Association, office in New Jersey, has outreach in several other countries. The website is 4HCM.org. May I suggest, contacting them and informing them about the fact that ONLY 8 women in 10,000 are diagnosed in Australia? I think the people in the organization would be shocked!

Jump to this post

@walkinggirl
even worse than the number diagnosed in Australia is that men are diagnosed at more than twice the rate as women. Since the genes are not sex linked, this smacks of misogeny.
When my previous cardiologist refused to discuss the possibility I might have HCM, or to arrange any tests that would identify it, I had to search for a cardiologist who might be more open to that diagnosis. Luckily I found one who was part of the research into the effectiveness of mavacamten.
I also found a new GP after the one I had at the time suggested my symptoms (which had hospitalised me several times) might be due to anxiety. (I was a psychologist - I knew anxiety was not causing my symptoms). My new GP asked if I had written to the previous cardiologist and expressed my views. I think I will do that, and pricide the link you suggest.
Thank you

REPLY

Hi @lucy4, I’m 57 and was diagnosed this past fall after I passed out walking across a parking lot six months earlier. One thing I’ve learned is that you have to drive your own health care. Meaning, that after my regular doctor and a local cardiologist (not a COE center) said they don’t know what going on, I referred myself to a COE and signed up with a cardiologist that is a specialist in HCM. That has made the difference! For example, the way the COE performs echos. The technician that did my echos at the COE told me how much training they go through to identify HCM and how the way they instruct the patient to “bear down” and so forth can make a big difference in the results of the echos. I would encourage you to find a COE or work with the HCM Association to find one as it will help you with your medical journey. I wasn’t truly diagnosed with HCM until I started working with a COE. We are working through finding the right treatment plan and have started on Camzyos, but I feel like I’m finally in the right place for my ongoing care. Best of luck to you and all my fellow big hearted friends!

REPLY

Thank you! Being in Canada we aren't able to just go and find one, but I can "demand" a referral.
I haven't passed out yet ...but have split second "grey outs" if things are right.
Iam so glad that you are able to work out a treatment plan!

REPLY
Profile picture for bepeacefulall @bepeacefulall

@lucy4 Hello, Lisa.
Hilde here, also from Ontario, 73. I am sorry to hear you are having such a hard time getting a diagnosis. It is hard sometimes to get the doctors to refer you to the right place.
In my case the diagnosis came so fast that I was not ready for it. I had a fainting episode when I was 66 and my nurse practitioner sent me to a number of doctors to find out the cause, among them London Health Sciences Cardiac Care Services at University Hospital in London, Ontario. They diagnosed HCM right away and wanted me to go on a beta blocker and have follow up every 6 months. Since I didn’t have any symptoms at the time I refused medication and care, having other things to do in life at the time. Over time, about 3 years later, my energy level was going down and I started to have swelling in legs and feet. Back to the n.p. who sent me to a local cardiologist with my old report. This doctor was very angry with me but sent me to the Peter Munk Cardiac Centre at University Health Network, Toronto General Hospital. I have been going there for about 3 years for detailed echocardiograms and have been on Bisoprolol since then which took care of the swelling just fine. Since February this year I have been on Camzyos and it seems to work as far as reducing the shortness of breath and a slight increase in energy.
They are the foremost centre for HCM in Canada and with your family history try to convince your doctor to refer you there. They also do genetic testing on you and your family members if they want to know if they have the condition. The doctors there are very informative and you can see all your test results by accessing the portal. You can also communicate with the doctors over the portal.
I was wondering how your father and grandfather were diagnosed or if they ever definitely were. I don’t know how long clinics have been able to diagnoseHCM or HOCM, but i think it is not all that long. I am quite sure my father had it, undiagnosed. He died in 1980.
Wishing you all the best in pursuing this. Let us know your next steps. And do try to continue doing things that are meaningful for you in life as much as possible. Having a chronic illness can eat you up and we are so much more than our condition. Much love ❤️.

Jump to this post

@bepeacefulall that had to be scary!...iam so glad you were able to get a quick diagnosis. I have not passed out. But have split second "grey outs" if things are just right.
I will keep pushing....I actually see my family Dr tomorrow and will be asking for testing. My grandfather did not get tested as he passed in early/mid 1960s, just diagnosed as far as I understand . My father has had testing and has a definite diagnosis. . his is LVOT, where latent mid cavity obstructive hyperdynamic hypertrophic cardiomyopathy was quickly mentioned on my 1st echo....from what I have read it's a harder form to diagnose and it does change?
I really appreciate you sharing your experience with me...it does help to know that I am not crazy lol.

REPLY
Profile picture for Linda, Volunteer Mentor @walkinggirl

@bepeacefulall Thank you for all the helpful information! Our Canadian neighbors navigate a different landscape and I'm glad you chimed in with specific suggestions for Lisa, @lucy4. Lisa, please also consider my previous suggestion to contact the Hypertrophic Cardiomyopathy Association 4hcm.org because they help people navigate their HCM worldwide. In fact, they recently announced they are now active in Portugal! It is true that HCM and HOCM went (and still is) often undiagnosed, even by cardiologists. I realize that my dad probably had an undiagnosed case as I remember his shortness of breath as he aged, died in 1999 but did tell me he had a mitral valve murmur. Grandma was not "feeling well" for a while before she died of an apparent heart attack in the late 1950's. Thank you, again, @bepeacefulall, @boatsforlife and @thehellyousay for all of your valuable inputs.

Jump to this post

@walkinggirl thank you for the suggestion. I will definitely look into it. I am happy to learn as much as I can about it...whether I end up having it or it be something else (I'm not sure it's something else).
Everyone's stories and suggestions have been great support and I appreciate every one❤️

REPLY
Please sign in or register to post a reply.