For the record:
Quick write-up of my end of April dobutamine stress echo test.
The test was done by a cardiologist and an echo technician.
Height and weight taken. Stripped to the waist. The cardiologist inserted a cannula in my arm through which the dobutamine and atropine would be infused. Echo wires were then attached to my chest. They asked if I had any particular allergies (none in my case).
Blood pressure was taken (and periodically recorded).
I lay on my side and an initial echo was conducted before the first of the drug infusions. Then the first dose of dobutamine was given through the cannula. This is automatically regulated and administered electronically.
The cardiologist said I would likely feel little impact on my heart rate with this first infusion. This was true. He did say there might be some tingling in my head and other parts of my body. The tingling did occur. Throughout this initial procedure, the echo technician was taking echo readings while I lay still.
Then after about three minutes a second dose was administered. This immediately increased my heart rate and breathing substantially. Not exactly a nice feeling but manageable. Continuous echo readings were taken.
Then some minutes later a third infusion was administered. This dramatically increased my heart rate and breathing up to approximately 85% of expected rate. It was almost overwhelming. Thumpingly fast heart rate pounding through my chest and substantial increase in rapid breathing (as though jogging). I concentrated on breathing steadily and regularly instead of following the inclination to breathe gaspy breaths (I’d been advised to do this – but I’m also familiar with meditation, breathing techniques, which helped).
This continued for two or three minutes as echo readings were taken live as I tried to remain as still as possible.
Finally, to push the heart to maximum expected rate, an atropine infusion was administered. Atropine is fast-acting, its effect immediate.
The sudden intense increase in heart rate and strength of breathing felt like something I’d have trouble sustaining for long. I breathed deep but much quicker and with increasing difficulty.
After two minutes or so, the cardiologist said the test was over and that the intense effects of the short acting atropine would quickly subside.
The peak heavy beating of my heart did subside relatively quick, but the thumping continued for a good fifteen minutes or more. Eventually everything settled and returned to normal.
There was a final echo test as the heart rate lessened.
After the fifteen minutes or so, I was asked to sit in the waiting room for twenty minutes to make sure there was no post-test reactions. But all was ok.
I was fairly spaced-out for the rest of the afternoon.
The echo technician and cardiologist were able to say before I left that the way my heart was reacting made it difficult to get a clear image of all parts of the valve and that it would require my valve specialist/caridologist to review the results.
Some weeks following this test, I received through the post a copy of my cardiologist’s report sent to my GP. It stated that during the dobutamine test there had been a ‘significant increase in the outflow tract gradient’ (my emphasis) during the test, making it difficult to assess the trans-aortic valve gradient. My cardiologist proposed to review these results at a stress echo meeting with her colleagues. I’ve heard nothing yet regarding this echo meeting.
In the meantime, I last week sent an email to my cardiologist asking if she considered a significant increase in the outflow tract gradient during a dobutamine test a normal, expected response (I was unsure whether such an increase indicates a problem). No reply, as yet.
My next official appointment is July.
So there we are – still not sure but admiring the paint in the Waiting Room.
Quick write-up of my end of April dobutamine stress echo test.
The test was done by a cardiologist and an echo technician.
Height and weight taken. Stripped to the waist. The cardiologist inserted a cannula in my arm through which the dobutamine and atropine would be infused. Echo wires were then attached to my chest. They asked if I had any particular allergies (none in my case).
Blood pressure was taken (and periodically recorded).
I lay on my side and an initial echo was conducted before the first of the drug infusions. Then the first dose of dobutamine was given through the cannula. This is automatically regulated and administered electronically.
The cardiologist said I would likely feel little impact on my heart rate with this first infusion. This was true. He did say there might be some tingling in my head and other parts of my body. The tingling did occur. Throughout this initial procedure, the echo technician was taking echo readings while I lay still.
Then after about three minutes a second dose was administered. This immediately increased my heart rate and breathing substantially. Not exactly a nice feeling but manageable. Continuous echo readings were taken.
Then some minutes later a third infusion was administered. This dramatically increased my heart rate and breathing up to approximately 85% of expected rate. It was almost overwhelming. Thumpingly fast heart rate pounding through my chest and substantial increase in rapid breathing (as though jogging). I concentrated on breathing steadily and regularly instead of following the inclination to breathe gaspy breaths (I’d been advised to do this – but I’m also familiar with meditation, breathing techniques, which helped).
This continued for two or three minutes as echo readings were taken live as I tried to remain as still as possible.
Finally, to push the heart to maximum expected rate, an atropine infusion was administered. Atropine is fast-acting, its effect immediate.
The sudden intense increase in heart rate and strength of breathing felt like something I’d have trouble sustaining for long. I breathed deep but much quicker and with increasing difficulty.
After two minutes or so, the cardiologist said the test was over and that the intense effects of the short acting atropine would quickly subside.
The peak heavy beating of my heart did subside relatively quick, but the thumping continued for a good fifteen minutes or more. Eventually everything settled and returned to normal.
There was a final echo test as the heart rate lessened.
After the fifteen minutes or so, I was asked to sit in the waiting room for twenty minutes to make sure there was no post-test reactions. But all was ok.
I was fairly spaced-out for the rest of the afternoon.
The echo technician and cardiologist were able to say before I left that the way my heart was reacting made it difficult to get a clear image of all parts of the valve and that it would require my valve specialist/caridologist to review the results.
Some weeks following this test, I received through the post a copy of my cardiologist’s report sent to my GP. It stated that during the dobutamine test there had been a ‘significant increase in the outflow tract gradient’ (my emphasis) during the test, making it difficult to assess the trans-aortic valve gradient. My cardiologist proposed to review these results at a stress echo meeting with her colleagues. I’ve heard nothing yet regarding this echo meeting.
In the meantime, I last week sent an email to my cardiologist asking if she considered a significant increase in the outflow tract gradient during a dobutamine test a normal, expected response (I was unsure whether such an increase indicates a problem). No reply, as yet.
My next official appointment is July.
So there we are – still not sure but admiring the paint in the Waiting Room.
