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ch665296f
@ch665296f

Posts: 11
Joined: Jan 05, 2016

ventricular tachycardia with apical hypertrophic cardiomyopathy

Posted by @ch665296f, Mon, Oct 8 7:23am

I have been diagnosed with ventricular tachycardia with apical hypertrophic cardiomyopathy with some scarring. I am currently taking metoprolol and verapamil to lower my blood pressure. In a month I will wear a holter monitor for a couple of days before I see my cardiologist again. I'm not sure what will happen next. If the monitor continues to show inverted t-waves, what would be the next step. I've been trying to do a little research myself, but come up with quite variety of scenarios. Is/can this be a serious issue? Any thoughts, advice, etc. would be appreciated. I am a 71 year old male.

REPLY

Hi @ch665296f. Welcome back to Mayo Connect. I have had concerns similar to yours, and I hope the two of us can gain some confidence from each other's experiences with hypertrophic cardiomyopathy. My HCM arises from a thickened external wall of the heart. Is yours attributable to thickening of the wall between left and right ventricles? I'm under the impression that, either way, our situations are similar.

For example, I had the Holter monitor reading three years ago, a few months after I was diagnosed with Atrial fibrillation (A-fib). As a result, my doctors put me on a beta-blocker (mine is Carvedilol, not Metoprolol). I started with a calcium-channel blocker (like your Verapamil). At the outset, I was encouraged that the beta-blocker and the calcium-channel blockers were double-duty medications — helping to regularize my heart rate while reducing my blood pressure. (Because of a unique kidney problem, I had to drop the calcium-channel blocker, which left too much fluid in my legs, in favor of Amiloride, a potassium-sparing diuretic.) On the whole, though, I feel a lot of similarities with your situation.

What will happen next? I think it's too early to predict — or to worry a lot about that. Your cardiologist has you "cooling out" for a month, rather than diving into some heavy treatment, and that gives you the chance to let the diagnosis — and the treatment — unfold over time as tests and your symptoms suggest. Why do I say that? It comes from a telling explanation from the following web page that speaks in laymen's terms: https://www.everydayhealth.com/heart-health-specialist/inverted-t-waves.aspx. Here's some comforting language from this report:

"T-waves are a part of a normal electrocardiogram (EKG), representing the electrical recovery . . . of the ventricles . . . after a contraction, or heartbeat. There are many reasons why T-waves can be inverted. We can see inverted T-waves, for instance, in the midst of a heart attack and in structural heart disease, such as coronary ischemia or left ventricular hypertrophy. On the other hand, we also may see inverted T-waves in people whose tests are completely normal . . . I have followed some patients like this for years that have never had a problem. They are asymptomatic and have otherwise normal hearts."

I was pleased to get this professional perspective on my HCM. My focus is on my A-fib is now almost asymptomatic, thanks to my medication regimen. And I hope you'll feel good about relying on your medical team to keep you informed and answer the questions you have about your concerns. In short, I've learned that poring over the Internet and medical literature is not better for my state of mind than an open, communicative relationship with my doctors.
Martin

@predictable

Hi @ch665296f. Welcome back to Mayo Connect. I have had concerns similar to yours, and I hope the two of us can gain some confidence from each other's experiences with hypertrophic cardiomyopathy. My HCM arises from a thickened external wall of the heart. Is yours attributable to thickening of the wall between left and right ventricles? I'm under the impression that, either way, our situations are similar.

For example, I had the Holter monitor reading three years ago, a few months after I was diagnosed with Atrial fibrillation (A-fib). As a result, my doctors put me on a beta-blocker (mine is Carvedilol, not Metoprolol). I started with a calcium-channel blocker (like your Verapamil). At the outset, I was encouraged that the beta-blocker and the calcium-channel blockers were double-duty medications — helping to regularize my heart rate while reducing my blood pressure. (Because of a unique kidney problem, I had to drop the calcium-channel blocker, which left too much fluid in my legs, in favor of Amiloride, a potassium-sparing diuretic.) On the whole, though, I feel a lot of similarities with your situation.

What will happen next? I think it's too early to predict — or to worry a lot about that. Your cardiologist has you "cooling out" for a month, rather than diving into some heavy treatment, and that gives you the chance to let the diagnosis — and the treatment — unfold over time as tests and your symptoms suggest. Why do I say that? It comes from a telling explanation from the following web page that speaks in laymen's terms: https://www.everydayhealth.com/heart-health-specialist/inverted-t-waves.aspx. Here's some comforting language from this report:

"T-waves are a part of a normal electrocardiogram (EKG), representing the electrical recovery . . . of the ventricles . . . after a contraction, or heartbeat. There are many reasons why T-waves can be inverted. We can see inverted T-waves, for instance, in the midst of a heart attack and in structural heart disease, such as coronary ischemia or left ventricular hypertrophy. On the other hand, we also may see inverted T-waves in people whose tests are completely normal . . . I have followed some patients like this for years that have never had a problem. They are asymptomatic and have otherwise normal hearts."

I was pleased to get this professional perspective on my HCM. My focus is on my A-fib is now almost asymptomatic, thanks to my medication regimen. And I hope you'll feel good about relying on your medical team to keep you informed and answer the questions you have about your concerns. In short, I've learned that poring over the Internet and medical literature is not better for my state of mind than an open, communicative relationship with my doctors.
Martin

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Martin. Thanks for the quick reply. I guess it's the waiting game, and the uncertainty that worries me the most. This whole adventure started the end of June when I mentioned to my GP during my "well man's" physical about certain symptoms I've been experiencing. As a result, I have had all the tests that were for the most part good. My blood flow is good. No arterial blockage of significance, but definite thickening of the muscle. The 24 hour holter monitor is what set off the alarms. At the present time, the meds don't seem to be doing much. I am incontinent due to a history of bladder problems as well as a prostatectomy combined with a diverticulotomy 18 months ago. So, when a new health issue arises, my anxiety level increases. At 71 I guess I should expect certain changes, but when you have been a very active person for so long those changes can be difficult to deal with. Again, thanks for the reply. I will try and keep you posted.
Dennis

@ch665296f

Martin. Thanks for the quick reply. I guess it's the waiting game, and the uncertainty that worries me the most. This whole adventure started the end of June when I mentioned to my GP during my "well man's" physical about certain symptoms I've been experiencing. As a result, I have had all the tests that were for the most part good. My blood flow is good. No arterial blockage of significance, but definite thickening of the muscle. The 24 hour holter monitor is what set off the alarms. At the present time, the meds don't seem to be doing much. I am incontinent due to a history of bladder problems as well as a prostatectomy combined with a diverticulotomy 18 months ago. So, when a new health issue arises, my anxiety level increases. At 71 I guess I should expect certain changes, but when you have been a very active person for so long those changes can be difficult to deal with. Again, thanks for the reply. I will try and keep you posted.
Dennis

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Glad we connected, Dennis (@ch665296f). I'll be around any time within a few hours if you want to "talk." We have other similarities medically. While not usually incontinent, I have to urinate about a dozen times a day — the result of bladder cancer 10 years ago, preceded by a TRP to remove a golf-ball size hunk of my prostate. I've tested clean of cancer every year since then, but my remaining prostate still gives me a little irritation once in a while. No intestinal consequences yet. If the meds aren't doing much, what had you hoped they might provide? Martin

Good morning . I am new to this site . I have read a few discussions on here . Learning alot for sure . So I have a sinus arrhythmia. Pardon the spelling . I guess I'm good . My symptoms are fluttering , palpatations , sometimes I get shoulder pain . Did the standard work up blood ekg eco stress test . They said I'm good . But they didnt tell me about the leaflets having a mild thickening and the tricuspid as well. I'm not sure what that is . The only way I found this out is by viewing my test results and read in my through their findings . If anyone has any info on this I would be more than appreciative for any feedback and knowledge. Hereately I have also been getting short of breath just at sitting or watching tv. Also fighting on going ear infections and massive hot flashes. Not sure if any of this is affiliated or if its other issues . Thanks again for the new member and kind words .

On Friday of this week, I finally get to see my cardiologist and review the results of my 48 hr. holter monitor. It has been a very long (4 months) to try and get a plan for my condition. The meds…metoprolol and verapamil have not worked. Plus, I have gained about 5-6 lbs. since this whole adventure started. I have always prided myself on being fit…ran marathons back in the day. The extra lbs. has been frustrating; especially since I haven't changed my diet. On top of it all, my wife will be having foot surgery on Thursday, and will not be able to put any weight on her foot for a month. She almost cancelled her appointment in order for her to be with me for an extra set of ears. We do have a good friend that will act as a substitute. I had prostate surgery 20 months ago, and as a result wear a diaper. Although my friend knows this, I'm a bit nervous if my diaper is visible. Any time I am front of someone in the medical field I get a little anxious about being seen in a diaper.I am trying to formulate a number of questions to ask the cardiologists, and could use any advice/suggestions/questions anyone can share. One question I have, if the drugs aren't working, what's the next step? Thanks for any help.

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