Cardiologists

I just met with dad's GP and his team (like six!) of cardiologists.

The first concern is dad's heart being relatively weak. It pumps significantly less than it did three years ago. Like all muscles, it atrophies when not used. Just like his leg and arm muscles, being sedentary has affected his hearts ability to do its job. Physical therapy and exercise for the rest of his body will help his heart just as well.

The second concern comes from the results of yesterday's ECHOcardiogram. I has the acronym right but he meaning wrong. This is the same tech for a sonogram of a baby in a pregnant mother. The echo showed a mass in dad's right ventricle. They are unsure what it is, but it is 99.999% NOT cancer.

As some of you may know, dad was born with a small hole between two parts of his heart. They call it a ventricular septal defect.  It is small enough that it never affected his life, and would have required major surgery to fix with a non-negligable risk of his heart stopping with all the negatives that comes with. One idea the doctors have is the piece of his heart that was supposed to cover that hole came loose and is flapping around. This would take major surgery to fix, and dad is not health enough for that.

That is why they are treating him for the other possibility brought up: the mass is a blood clot. A clot could have started small and gained size over time, reaching it's current size. The treatment for this is simple: IV heparin, an anti-coaggulant.

The cardiac team is planning a second echo with contrast. They inject dad with a sort of dye to allow a better view. As you can imagine, since even a resting heart beats sixty times a minute, figuring out what something the size of a small marble is in a blurry black and white picture is very hard.

The best case is a clot that is smaller on the second echo, being reduced in size by the heparin. Next would be a flap of heart tissue that is attached firmly to the rest of the heart, so they can just ignore it. A clot that doesn't respond to heparin would be worse and a heart piece just about to separate would be bad.

The added concern for a clot, if that is the issue, is it dislodging from his heart and going somewhere bad, like the brain, causing a stroke. If it does dislodge, the neurologists can go in and break it up into small pieces, minimizing damage.

This is all supposition. It is possible for the blur to be one or none of these.

The team overseeing his care is top notch. New York Presbyterian has been ranked as the #1 hospital in the state fourteen years running. I trust the people here to get the best information, make the best decisions to get the best outcome possible.

Dad is in the best hands he could be.