Cath update

Fortunately, there's not much to add to Jenn's posting, as all went well (ie, no surprises). My coronary arteries are "pristine."

The first person to thread a tube into an artery (his own brachial, as it turns out ... the femoral artery in the groin is generally the preferred approach today), snake it up to the heart, and snap an X-ray was a physician by the name of Werner Forsmann, sometime in the first half of the 20th century. Crazy SOB, if you ask me. Flash forward to 2010, and this procedure is on par, experience-wise, with a trip to the dentist. This was cath #2 for me, lifetime, and I can safely say they're not worth sweating over. (You can't anyway - the cath lab is typically kept around 60 degrees.)

In addition to the arterial assessment, the cardiologists take some other measurements, and again there were no surprises here. My heart muscle overall is quite stiff, which is common in HCM. The resting gradient was 30, in line with what we've seen before on echo (remember folks - normal is zero). It spiked to 120-200 after he generated a premature ventricular contraction (a PVC, like a skipped heartbeat) by "tickling" the inside of the ventricle. This is called the Brockenbrough-Braunwald-Morrow sign, and it's just really cool how they do this: they place a catheter with 2 lumens, one in the left ventricle and one in the ascending aorta; force a PVC; and take pressure tracings. Differences in pressure after the PVC = gradient = obstructive HCM. It's what confirmed the HCM diagnosis in October 2008, and I made the cardiologist do it again today just to be sure.

Tomorrow is the last set of pre-op appointments, but no procedures or tests that I'm aware of. Both sets of parents arrive in Cleveland tomorrow afternoon.

Take care,

Michael