My internist recently sent me to a cardiologist. I'm uncertain why, though
I was complaining of excessive tiredness and stated that if this keeps up I
will be a frail old man in a few years.
A Cardiolite - adenosine stess test showed abnormal perfusion of the apex.
A resting echo appeared to show reduced ejection fraction, 45, stiffness,
enlargment of left ventricle and atrium.
Cardiac catheterization was suggested. As I had no symptoms other than just
being excessively tired much of the time and what I considered orthostatic
hypotension, I asked if it was possible that the Cardiolite stress test
result was an artifact.
To check that, a dobutamine-atropine stress echo study was done. I was told
that the wall motion was abnormal and that there was a modest drop in
ejection fraction when stressed.
Again, cardiac catheterization was recommended and I was told to anticipate
angioplasty or perhaps even a by-pass.
Cardiac catheterization studies revealed a normal heart. Normal blood flow,
proper pressures in the ventricle, proper pumping. The cardiologist stated
that he estimated the ejection fraction in the 60s just by watching how the
heart pumped the contrast dye.
Well, if this had been done in a fee for service situation I would be
thinking that I had been led down the primrose path and improperly relieved
of my money.
As it happens, this work was done by an HMO who's docs are salaried. Hence,
no motive for churning.
Also, my personal take on the docs involved is positive. I like them and
believe that they are in fact competent.
My question....Does this sort of thing happen with some regularity, or was
this a very odd or unusual set of events?