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DrDLove
DrDLove, MD
Category: Cardiology
Satisfied Customers: 18132
Experience:  Cardiology Expert
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Why do cardiologists not explain what is happening when

Customer Question

Why do cardiologists not explain what is happening when there are problems?
The making light of problems or not informing the patient leaves the patient undereducated about his/her own condition which can be harmful in many ways.
Submitted: 1 year ago.
Category: Cardiology
Expert:  DrDLove replied 1 year ago.

This is not a universal trait of all Cardiologists.

What happened in your situation?

Customer: replied 1 year ago.
I have a family history of all females having heart attacks and strokes - both grandmothers and mother. I have kept myself as educated as possible about what's happening heart wise. I look at my ekgs, asking questions when something different appears.
I have a heart loop monitor implanted due to several blackouts. The tech told me I have heart failure when I sent in a report and had asked a question about some of the symptoms I was experiencing. I also belong to a group with my insurance that has nurses available 24/7. I called and talked with her about the same thing. I received the same answer. All I get from the electrophysiologist is I have normal sinus rhythm which doesn't explain what causes the symptoms I have. It seems to be a waste of time to record events when all I get is that for a response. I am having surgery next week and had to go for clearance. I explained the 4 days I didn't take bumex and the amount of lung and throat congestion I awoke with on the fifth day. Now I'm headed for an echo tomorrow. This was the first mention of possible CHF on his part.
Expert:  DrDLove replied 1 year ago.

I assume that you reported symptoms indicating heart failure on the report to the tech and the discussion with the nurse, and if similar symptoms were relayed to the Cardiologist, then there should have been a similar determination.

You do not say why you were prescribed Bumex, but this is one of the medicines that are frequently used for heart failure. If so, then the doctor also should have explained the diagnosis at the time that the Bumex was prescribed.

As I said above, poor communication a lack of explanation is not a universal trait among Cardiologists. Since this is important to you, it would be appropriate to consider seeing a different Cardiologist.

Customer: replied 1 year ago.
I have seen at least five different cardiologists over the years and the current one is more caring and makes some attempts to answer me truthfully - certainly does a far better job than anyone else has. While he may not give me the information I'm looking for, I do feel he is looking after my best interests and I trust him to continue to do so. I did not experience that with any of the others. I have another question. I have sob on going up and down stairs, which because of physical problems with my feet and legs is not something I do quickly. I tire easily. I have difficulty pacing myself because I don't have a clear idea of what is wrong. How much do I push? When I get tired I have no choice but to rest as exhaustion is disabling. i know exercise is important so I struggle with pain and desire to accomplish things. With the sob there are times when I have no choice but to stop until I can catch my breath. I've been telling myself it is deconditioning since there has not been any other explanation given. I do expect things to get better the more I pursue physical activities which are naturally limited due to CRPS, foot deformity from surgery, small fiber neuropathy, etc.but that has not really been happening. If I knew , was told, what I can expect from what is hampering me, that I should be able to expect and do, things might work out better for me and that is why I search for dx and explanations.
Expert:  DrDLove replied 1 year ago.

Shortness of breath with exertion is a common symptom of heart failure. There are other possible causes, such as chronic lung disease, but since there is other evidence of heart failure, it is vastly most likely that the heart failure is causing your shortness of breath with exertion.

In someone with shortness of breath with exertion from heart failure, it is not wise to push it when shortness of breath develops. You are correct to stop the exertion until the shortness of breath eases. It also would be correct to discuss with your doctor about intensifying treatment for the heart failure so that the shortness of breath does not occur, or at least will only occur at greater amounts of exertion.

Customer: replied 1 year ago.
What kinds of treatment are there for heart failure?
Expert:  DrDLove replied 1 year ago.

The specific treatment will be oriented towards the findings on the echocardiogram, but will frequently include ACE inhibitors or angiotensin receptor blockers, beta blockers, or long acting nitrates, in addition to the diuretics.

Customer: replied 1 year ago.
I believe heart failure is due to the inability of the heart to meet the needs of the body. What kinds of things are present to cause this to happen? Since I have a strong history of heart problems, are genetics involved to certain types of things that don't work well? I guess I need to be a bit kinder to myself instead of pushing so hard and being disturbed that I can't do all the things I think I need to do. What effect will general anesthesia have on heart failure since it's not been dx?
Expert:  DrDLove replied 1 year ago.

It varies. Sometimes it is a part of the heart muscle that is weak, such as from poor blood supply to the heart muscle or a heart attack, which is the most common cause of heart failure, and the remaining muscles work harder to compensate. Sometimes all of the muscle is diffusely weak. Sometimes there are anatomic conditions that affect the ability of the heart to pump blood, such as valve disease. Family history is a risk factor for certain of these conditions, and certainly for the problem with poor blood supply to the heart.

The issue with general anesthesia is more when the heart failure is not well controlled, because the anesthesia places extra stress on the heart and lungs.

Customer: replied 1 year ago.
On my ekg of today and many times in the past was left anterior fascicular block and incomplete right bundle branch block. Left axis deviation also always shows up. Many years ago my PCP pointed out where I must have had a silent heart attack. Every once in a while it shows up on the computer read out. From what I've read about LAFB, that silent heart attack could have started that process. Is that right?I also read they are making more discoveries about the long term effects of LAFB. I also have autonomic dysfunction which messes me up once in a while - dizziness, low, low blood pressure, Afib every once in a while. I guess I am looking for someone to say there is a problem, not terrible, but something that needs to be dealt with. Perhaps my cardiologist is dealing with it but just not sharing as much as I would like. I will try again to express myself better than I did today. Perhaps writing it would be more helpful. My stress level has recently been reduced a bit and I'm sure that is going to be a big help. Is that so?
Expert:  DrDLove replied 1 year ago.

Yes, a heart attack is a common cause of an LAFB, as well as an incomplete right bundle branch block. Yes, reducing stress can be helpful.

Customer: replied 1 year ago.
Thank you for your help.
Expert:  DrDLove replied 1 year ago.

You are most welcome.

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