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What does stiffness of the heart imply?

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Posted on Mon, 14 Jul 2014
Question: I have just been told that I have a slightly stiff heart, what does this mean? I have recently had two cases of AF. Should I be worried?
More information - My two cases of AF were reversed in hospital with medication within 18 hours. Since being prescribed Fecanide, about 6 weeks ago I have not experienced another episode of AF. However today i received a letter from the consultant saying that a recent heart scan has revealed a slightly stiff heart. He does not give any furhter information so i have no idea what this means - should I be concerned? I am 55 years old, reasonably fit, I do not have high blood pressure although my bad cholesterol is a little high 3.70 and combined Cholestrol level is 5.66. I have also had ED since I was 40. I do not smoke although I do drink two or three glasses of red wine a day. My weight is only slightly over what it should be for my height. I run two companies so stress levels are quite high and I regularly have feelings of Anxiety and sometimes breathlessness. My father had vascular and heart disease and died at the age of 76.
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Answered by Dr. Michelle Gibson James (6 hours later)
Brief Answer:
usually means problems relaxing

Detailed Answer:
HI, thanks for using healthcare magic

The blood from the different parts of the body goes to the right side of the heart which then sends it to the lungs to get oxygen. From the lungs, it goes to the left side of the heart . The left side then sends it out the body to be used.

When the right side is receiving the blood from the body and the left side is receiving blood from the lungs, these sides relax, to allow in the blood. It is called diastole.

When the right side is sending blood up to the lungs and the left side is sending out blood, they contract. This is called systole.

Stiffness of the heart normally implies that there is a problem with relaxation of the heart. ( a problem with diastole)
This means it has difficulty relaxing to get the heart from the body (right side) and from the lungs (left side).
This could affect the amount of blood the heart receives to function.

The 'stiffness' can be mild with no significant effect on heart function or it can be severe.

Your doctor would be able to tell you the extent of the problem

I hope this helps, feel free to ask any other questions
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Michelle Gibson James (9 hours later)
Dear Dr XXXXXXX thank you for your reply. - I have a few additional questions:
-Please could you let me know What causes stiffness of the heart?
- Is this the start of heart disease ?
- Does this condition mean that I have an increased risk of a heart attack or stroke?
-It is usual for mild stiffness of the heart to eventually become severe?
-Can stiffness of the heart lead to other heart conditions?
-What are the symptoms of a Stiff heart?
-I regularly experience feelings of anxiety and breathlessness, is this a result of the slight stiffness of my heart?
- Can the condition be reversed and if yes, how?
- If my heart is receiving insufficient amounts of blood, how can this affect my health?
- Are there any foods or drink that I should avoid as I have a slightly stiff heart?
- Can excercise help or reverse the condition?

Thank you

Kindest regards
XXXXXXX
doctor
Answered by Dr. Michelle Gibson James (1 hour later)
Brief Answer:
will try to answer all for you, hope helps

Detailed Answer:
HI

(2)It is a form of heart disease.

(1)There are different causes, some of them are: (a) hypertrophic cardiomyopathy- when the heart thickens and becomes stiff, the exact cause of this condition is unknown
(b)diseases where there are substances deposited into the heart (conditions such as amyloidosis, hemochromatosis, sarcoidosis, glycogen storage disease of the heart)
(c)some autoimmune diseases such as scleroderma
(d)hypertension which you stated is not a factor
(e)idiopathic- the cause cannot be identified

(3)The risks depend on how the severity of the problem. There may not be an increase risk of heart attack or stroke but if the problem is significant there may an increased risk of heart failure.
Heart failure is a condition where the heart cannot meet the demands of the body

(4)There is a risk of progression but this can be delayed by the use any appropriate therapy given by your doctor

(5)it can lead to heart failure in some persons

(6)if it is mild, there may be minimal symptoms.
In others there may symptoms such as shortness of breath, fatigue, swelling of the lower limbs

(7)Anxiety on its own can lead to shortness of breath without the presence of heart disease

(8)in most cases reversal is not possible. Treatment is usually geared towards restricting progression

(9)If the heart is not relaxing to take in blood from the rest of the body-less blood going to the lungs to receive oxygen - less blood going to the left side of the heart-less blood with oxygen being sent to the body. The body needs oxygenated blood to work

(10)no particular foods and drinks

(11) exercise can help but you would need to consult your doctor before attempting any exercise program

Please feel free to ask anything else
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Michelle Gibson James (2 days later)
Dear Dr XXXXXXX

Thank you for your very informative respose.

Would you suggest any additonal test or perhaps even a second opinion?

So far I have had a cardiac ultrasound which showed the results of a slightly stiff heart.

Additionally I have had a stress test, although I believe this was not that useful as my heart rate was submaximal due to my Bisoprolol medication.

Should I also have any of the following tests?

1) Nuclear stress test?
2) Cardiac pet scan?
3) CTA scan?
4) Heart Pressure test?
5) Lung check up?

What therapy & medication is appropriate for a slightly stiff heart? It is safe for me to still continue taking Flecanide? I was advised previously that it was only safe to take Flecanide for my Atial Fibrilation if my heart was strong, any problems with my heart and I should immediately stop taking Flecanide, would you agree with this?

Thank you again

Kindest regards

XXXXXX

doctor
Answered by Dr. Michelle Gibson James (5 hours later)
Brief Answer:
treatment is mainly preventing worsening

Detailed Answer:
HI

The echo (cardiac u/s done) should have given detailed information on the heart function. It can provide info on how the different sides are contracting and relaxing, how much blood is being pumped out with each contraction and how much remains.
It would also show if there are any aspects of the heart walls that are not working as well as the others.

For now along with the info from the stress test, this may be enough for you. If there are any changes in your symptoms or change in examination findings then your doctor may either repeat the echo and do additional testing.

In terms of treatment, the main aspect is to prevent progression. This would involve controlling any risk factors for heart disease such as keeping your blood pressure normal as it is right now, controlling cholesterol, increasing activity (this should be done under your doctor's guidance).
If any symptoms develop indicating the heart is not able to do its job well then other medications would be added.

In terms of the flecanide, your doctor would assess the echo to see the degree of impairment of the heart function. If it is not significant then it would be continued but it would depend on how it appeared to be functioning.

Most persons with a fib are also on anticoagulation because the condition is associated with increase risk of clot formation which can increase the risk of heart disease and a stroke.
The most common anti coagulant is warfarin though there are some newer agents available.

Hope this clears up your questions, if there are additional queries feel free to ask
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Michelle Gibson James

General & Family Physician

Practicing since :2001

Answered : 16811 Questions

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What does stiffness of the heart imply?

Brief Answer: usually means problems relaxing Detailed Answer: HI, thanks for using healthcare magic The blood from the different parts of the body goes to the right side of the heart which then sends it to the lungs to get oxygen. From the lungs, it goes to the left side of the heart . The left side then sends it out the body to be used. When the right side is receiving the blood from the body and the left side is receiving blood from the lungs, these sides relax, to allow in the blood. It is called diastole. When the right side is sending blood up to the lungs and the left side is sending out blood, they contract. This is called systole. Stiffness of the heart normally implies that there is a problem with relaxation of the heart. ( a problem with diastole) This means it has difficulty relaxing to get the heart from the body (right side) and from the lungs (left side). This could affect the amount of blood the heart receives to function. The 'stiffness' can be mild with no significant effect on heart function or it can be severe. Your doctor would be able to tell you the extent of the problem I hope this helps, feel free to ask any other questions