Chapter Seven #2
“Olivia? I’m Dr. Kasey.” A woman in her fifties enters, wearing a white coat over black pants and a reassuring smile. She’s smaller than I expected, with short dark hair and the kind of presence that immediately makes you feel like you’re in capable hands.
“Thanks for seeing me,” I say, though I’m not sure thanking someone for potentially delivering bad news makes sense.
“Dr. Jensen’s referral mentioned you’ve been having some symptoms.” She settles onto the rolling stool and opens my chart. “Tell me what’s been going on.”
So I do. I tell her about the racing heart that feels like it’s trying to escape my chest, the dizziness that comes out of nowhere, shortness of breath. I tell her about soccer practice, about missing shots because I can’t concentrate when my heart is beating so hard I can feel it in my throat.
Dr. Kasey listens without interrupting, occasionally making notes. When I finish, she looks up from the chart.
“I see you’ve recently obtained your paternal family history. That’s helpful information to have.”
“Seems you have family history of heart problems. Heart failure in multiple relatives, early bypass surgery, irregular rhythms. These conditions can have genetic components.”
“Does that mean I have them too?”
“Not necessarily. But it does mean we need to be thorough in our evaluation.” She sets the note aside and picks up her stethoscope. “Let’s start with listening to your heart.”
The metal is cold against my chest, even through my T-shirt. She moves it around, listening intently while I try to breathe normally and not think about all the ways my heart might be broken.
“Take a deep breath,” she says. “Now let it out slowly.”
I follow her instructions, acutely aware of every beat, every pause between beats. Is it beating too fast? Too irregularly? Are there murmurs or extra sounds that shouldn’t be there?
“Hmm,” Dr. Kasey says, which is exactly the kind of noncommittal sound that makes your anxiety spike.
“Hmm good or hmm bad?”
“No. Nothing immediately alarming, but combined with your symptoms and family history, I’d like to run some tests.” She hangs the stethoscope around her neck. “An EKG to look at your heart’s electrical activity, and an echocardiogram to see the structure and function.”
“How long do the tests take?”
“The EKG is quick, just a few minutes. The echo takes about thirty to forty-five minutes. We can do both today if you’d like, or schedule them for another time.”
“Today,” I say quickly. “I want to know what’s going on.”
Dr. Kasey smiles. “I thought you might say that. Let me get the technician set up.”
She steps out of the room, leaving me alone with my racing thoughts and the anatomical heart poster. I text Derek.
Me
Having tests done now. EKG and echocardiogram. Should know more soon.
Derek
You’ve got this. I’m right here when you’re ready.
The technician who comes in is younger than Dr. Kasey, maybe early thirties, with a cheerful demeanor that feels forced. She wheels in a machine that looks like something from a science fiction movie.
“I’m Sarah, and I’ll be doing your EKG today. This is completely painless, just some sticky electrodes on your chest and we’ll get a reading of your heart’s electrical activity.”
She has me lie back on the examination table and lifts my shirt to place the electrodes. The sticky patches are cold against my skin, and wires snake from each one back to the machine. I feel like I’m being prepped for some kind of experiment.
“Just try to relax and breathe normally,” Sarah says, pressing buttons on the machine. “This will only take a few minutes.”
Easy for her to say. I stare at the ceiling tiles and try not to think about all the ways this test could go wrong. The machine starts printing out a long strip of paper covered in jagged lines that supposedly represent my heart’s rhythm.
“All done,” Sarah says, peeling off the electrodes. “That wasn’t so bad, was it?”
“What do the results look like?”
“Dr. Kasey will review everything and discuss the results with you.” The non-answer every medical professional gives when they don’t want to speculate.
Next comes the echocardiogram, which involves more gel than I expected and a technician pressing an ultrasound wand against my chest while staring at a screen full of moving gray and black shapes that supposedly represent my heart.
“Is that what my heart actually looks like?” I ask, watching the rhythmic pulsing on the monitor.
“Pretty amazing, isn’t it?” the technician says. “Four chambers working in coordination, beating about a hundred thousand times a day.”
“What if they’re not working in perfect coordination?”
“That’s what we’re here to find out.”
The tests take longer than expected, and by the time I’m back in the examination room waiting for Dr. Kasey, my anxiety has ratcheted up to near-panic levels. I check my phone. Derek’s sent three encouraging texts and Maya’s added a string of heart emojis to our group chat.
Dr. Kasey finally returns, carrying a folder thick with test results.
“Well,” she says, settling back onto her stool. “I have some answers for you.”
My heart pounds as I wait for her to continue.
“Your EKG looks normal, no electrical abnormalities or dangerous rhythms. That’s good news.” She opens the folder and pulls out what looks like ultrasound photos. “The echocardiogram shows your heart structure is normal overall, but there is one finding I want to discuss with you.”
Here it comes. The bad news I’ve been dreading.
“You have mild tricuspid regurgitation. That means one of your heart valves—the tricuspid valve—isn’t closing completely, so a small amount of blood flows backward when your heart beats.”
Tricuspid regurgitation. Exactly what Jeremy has. Exactly what was written in blue ink on Mom’s sticky note.
“Is that serious?”
“In your case, it’s very mild. Many people have some degree of tricuspid regurgitation and live completely normal lives. It’s probably what’s been causing your symptoms—the racing heart, occasional chest discomfort, the dizziness.”
“So I inherited it from my dad.”
“Very likely, yes. The good news is that mild tricuspid regurgitation rarely progresses to something more serious, especially in young, healthy people.”
Relief floods through me, followed immediately by a strange sense of connection to Jeremy. We share the same heart defect, the same mild imperfection that makes our hearts beat a little differently than everyone else’s.
“What does this mean for my life? For soccer?”
“You can continue playing soccer. You can exercise normally. Just pay attention to your body, and if you experience severe chest pain, fainting, or extreme shortness of breath during activity, you should stop and seek medical attention.”
“Will it get worse?”
“Not necessarily. We’ll monitor it with annual echocardiograms, but many people with mild tricuspid regurgitation never progress to anything more serious.” She hands me a packet of information. “This explains the condition in detail, plus some lifestyle recommendations.”
I take the packet, my hands steadier than they’ve been all day. “So I’m not dying.”
Dr. Kasey smiles. “You’re definitely not dying. You have a very manageable condition that we’ll keep an eye on. Try not to worry too much about it.”
“One more question,” I say as she starts to stand. “If I have kids someday, could I pass this on to them?”
“It’s possible. Heart valve abnormalities can have genetic components. When you’re ready to start a family, genetic counseling might be helpful to understand the risks.”
After she leaves, I sit in the exam room for a moment, processing everything.
I have tricuspid regurgitation. Mild, manageable, but real.
I inherited something concrete from Jeremy’s side of the family, not just his green eyes or stubborn chin, but an actual medical condition that connects us in a way I never expected.
But I’m not dying. I can still play soccer. I can still have a normal life.
ME
All done. I have the same heart condition as my dad. Mild, nothing serious. Coming out now.
Derek
That’s amazing news. Can’t wait to hear everything.
As I walk back through the waiting room toward the exit, I pass the woman who was nervously flipping through magazines when I arrived.
She’s still there, still waiting, still bouncing her leg.
I want to tell her that whatever she’s facing, whatever test results or diagnoses wait for her, she’s braver than she knows for being here.
Instead, I push through the doors into the afternoon sunshine, where Derek is already waiting by his car, book forgotten in his eagerness to see how I’m doing.
“So?” he says as soon as I’m within hearing distance.
“So,” I say, pulling out my phone to text Mom the news. “Turns out I really do have my father’s heart.”