On September 16, I had a cardiac ultrasound.
My cardiologist didn't call me afterward. He didn't schedule a follow-up to walk me through the results. He posted his notes to my patient portal on MyChart and that was that.
I opened the report on my computer.
Ejection fraction. Biplane Simpson's method. Mitral regurgitation. TAPSE. E/E' ratio. LV mass index. Regional wall motion abnormality. Trivial pericardial effusion.
I didn't understand most of it.
I'm five years post heart attack and obsessively tracking my own recovery. I read research papers for fun (not really). And I still couldn't make sense of what I was looking at.
That's not a criticism of my cardiologist. He's probably very thorough and careful. He must have dozens of other patients needing very URGENT care. (At least that’s what I tell myself).
This is the reality of cardiac care in 2026. I waited 5 months for this appointment, Your results arrive as a message, your doctor posts a note, and you are largely on your own to figure out what it means.
So I did what I always do.
I started asking questions. I turned to multiple AI research tools, and carefully compared results. I pulled up the research. I compared the numbers to my last 2024 ECHO. I dug into what each metric actually measures — not the medical definition, but the plain English version that tells you what's actually happening inside your chest.
Slowly, things started to make sense.
Five metrics. Five years after two blocked arteries and six stents.
The mitral valve — the door between the upper and lower left chambers of my heart — had been leaking moderately in 2024. A meaningful gap that made my heart work harder with every beat.
By September 2026, the leak had reduced to trace. Almost closed. Without surgery. Without a new valve.
The pulmonary pressure — elevated in 2024 because blood was backing up from that leaky valve — had normalized. The backup cleared when the valve improved.
The LV mass index — the weight of my heart wall, thickened from years of elevated blood pressure — had dropped from 116 to 97.9. From borderline hypertrophy back into the normal range. The wall had thinned. The heart was compensating less.
The right ventricle — which had been straining under elevated lung pressure — had recovered. TAPSE from 1.6 to 1.8. Normal.
The diastolic function — how well my heart relaxes and fills between beats — had gone from Grade I dysfunction to normal filling pressures.
In 2024 my ejection fraction (the heart's pumping power) was estimated visually at 50-55%. This time it was measured precisely at 55%. The methodology improved — and the number held.
Not because of a drug targeting any of these specifically. Not because of surgery. Because the metabolic environment that was creating the pressure and the inflammation and the stiffness — that environment had changed.
My cardiologist's note said: no significant changes from 2024.
He was referring to the scar. The akinetic apex, the hypokinetic septum — the permanent damage from August 2021. He's right. That will never change.
But everything around that scar? It improved.
Five years. One tachycardia event. One flu that changed my sleep for six months. One arrhythmia at 3am that I'm still investigating. Everything the past five years threw at this heart.
My heart didn’t just survive. It got better.
I want to be honest about something.
I didn't feel triumphant when I finally understood the results. I didn't pump my fist or tear up.
I felt something quieter than that.
Grateful. And more determined than ever.
Because the ECHO also showed me things that aren't fixed. My ejection fraction of 55% is the floor of normal, not the middle. My aortic valve is slowly calcifying. My resting heart rate was 91 during the scan (more on that in the next issue). There's still work to do.
The investigation isn't finished.
But the heart held its defenses. And for today, that's enough.
Dennis
Cardiac Survivor · Your Friend in Recovery
Spokane, Washington
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P.P.S. First time here? The glossary has plain-English definitions of every term in this letter: newsletter.cardiacsurvivor.org/p/glossary