Tuesdays with Chandra: The matters of heart

What prompted my cardiologist friend to summon me to the hospital the next morning and repeat the ECG and Echo? Was it because he had access to these equipments and was qualified to examine the visuals and interpret the results? Was it because of the friendship we shared? What did the earlier ECHO report say that turn the cardiologist impatient to repeat the tests? I had no answer and Google gave me way too much information to assume and analyze.

I honored my friend’s summon, sacrificed my coffee and showed up the next morning. I was taken to emergency; there was no sweat on my forehead, no panic on my face and with laptop hanging from my shoulder. And for the emergency room staff I looked very normal and must have appeared to have walked into the wrong building. I had never been to an emergency room and not seen the mood of doctors and ambience in the room. Nevertheless, the doctor order for an ECG and within seconds I was disarmed of my belongings, made to lie on the examination table. I stared at the roof while the leads were connected to my left side of my chest and when everything was ready the ECG machine failed to work! Even the ECG machine seems to have breakdown in the emergency room. It looked like my waves from my heart short circuited the ECG machine!

Finally, another ECG machine was brought over to record the unheard messages from my heart on a paper. Wouldn’t every lover and spouse want to hear and see the unheard messages from the heart, not just around Valentine’s day, but even on other days? The technician and doctor stared intently at the paper and the tip of the pen recording communication from my heart. It didn’t take much time to fill the A4 sheet and it was all black and white!

I heard the doctor say “incomplete RA and RV” and nothing else. I didn’t know if this recording was good or bad, but the doctor looked pensive. Is that a common demeanor in the emergency room? Those set of 8 lines on the graph paper meant nothing to me. All I knew was that I was hardly 10 m away from the ICU, but the results from the ECG didn’t need me to go that side. While he waited for me to get dressed he called his colleague over the phone and asked him to come to the Echo room on the first floor. We took the stairs, and he raced like a doe, while I was struggling to keep pace with him and I had no room question the scribble on the paper filled with mirco checks.

He ordered the Echo technician to prepare for the procedure as we got into the room. This was my second experience with Echo and I knew the breathe-in, hold, breathe-out, and lying down on the side routine very well. And over the next 20 minutes the two cardiologists and the Echo technician were staring at the monitor that showed the contours of my heart. They were looking for the culprit(s) aka anomalies. I heard them search for evidences of congenital defects in my heart. One of the said, “show me the septum and the valves” and the other said, “let us rule out venous sinuous” and they kept searching for everything they learnt in their anatomy class. At times they turned up the volume on the machine to hear the symphony composed in my heart. Now there was music to go with the visuals. Was the symphony normal? Was there an extra beat? Did their monitors show the same result that was seen by the other technician yesterday? I heard the beat, I saw the contours and to me the visual on the monitor was hazy and beats had no rhythm. But from the diagnosis and the discussion I knew “matters of heart” for me are always hazy and difficult to understand.

At the end of the procedure the cardiologist and the technician independently and together validated the earlier finding “dilated RA and RV”, though they ruled out a few congenital defects, but they had no conclusive evidence of what was causing the dilatation of the right side of the heart. I was ahead of the diagnosis and asked them if I needed a surgery to correct the dilation. Since no one has ever gone this close to my heart, I was petrified.

To ascertain the exact reason for dilation they suggested that I undergo Trans Esophageal Echo (TEE). This would help them rule out other abnormalities and pin-point the exact cause. Now I was asked to show up again tomorrow morning in empty stomach. I felt like a lab rat and at times proud that my heart was a piece of puzzle to the cardiologists. But I was still smiling and energetic after the 14 hour fast and invited the doctors for a cup of coffee. While one of them took my offer, the other proceeded to attend other patients in the queue. Over the cup of coffee I asked the doctor about his gut feel on the diagnosis and preparation for tomorrow’s procedure.

I know matters of my heart must be equally confusing and sounding ominous to you. Next week will bring more clarity. So come back soon! Until then go easy on sugar, fat and carbs. Importantly learn to listen to your heart.