Exercise Test

[daVinci]

Had an exercise/ treadmill test today, was wondering if anyone else had had one of these on their valve journey prior to surgery?

And if so what results/ symptoms did you get during the test?

My blood pressure falls at peak exercise (I think below/ towards my baseline) which probably explains why I feel so rubbish at the top of a hill/incline!

I can see that in certain situations this is an indication for surgery in the guidance.

Would love to hear your experiences.

 

[carolinemc]

Had an exercise/ treadmill test today, was wondering if anyone else had had one of these on their valve journey prior to surgery?

And if so what results/ symptoms did you get during the test?

My blood pressure falls at peak exercise (I think below/ towards my baseline) which probably explains why I feel so rubbish at the top of a hill/incline!

I can see that in certain situations this is an indication for surgery in the guidance.

Would love to hear your experiences.

I had the different one, lying down while they did an echo and did the stress test. I used to get the other that you sat down in a chair and they give you a shot to stimulate CHF and it was not fun. The treadmill test is different and wish you the best, not an easy test to do.

 

[dornole]

I had a treadmill test (with echo) once because I thought it was becoming symptomatic but really my feelings of shortness of breath were anxiety related. Normally just lying down echos but they ordered the treadmill one based on what I was describing.

 

[Beach77]

I had a echo stress test prior to surgery and didn't enjoy it too much. It was for preparations for the TAVR procedure. (I ended up changing my mind and went with the OnX valve.) I've just looked at the report again. The test was ended because I became excessively hypertensive with stress (per report) but I was having a hard time catching my breath. I wanted to stop sooner but my doctor asked me to keep going a little longer, if I could. I had four doctors in the room with me, plus a technician. I was at a teaching hospital; one Dr. was teaching another, with the technician doing the work. Then, right before my test started my Dr. came in with the TAVR Dr. The conclusion was my stenosis increased with exercise. My BP was normal before the test but "The patient became excessively hypertensive with stress" during the peak of the test.
Hope this helps!

 

[Humboldtgrrl]

I had a echo stress test prior to surgery and didn't enjoy it too much. It was for preparations for the TAVR procedure. (I ended up changing my mind and went with the OnX valve.) I've just looked at the report again. The test was ended because I became excessively hypertensive with stress (per report) but I was having a hard time catching my breath. I wanted to stop sooner but my doctor asked me to keep going a little longer, if I could. I had four doctors in the room with me, plus a technician. I was at a teaching hospital; one Dr. was teaching another, with the technician doing the work. Then, right before my test started my Dr. came in with the TAVR Dr. The conclusion was my stenosis increased with exercise. My BP was normal before the test but "The patient became excessively hypertensive with stress" during the peak of the test.
Hope this helps!

Does Not sound like a Fun experience, but perhaps it helped clarify your valve decision?

 

[Beach77]

Does Not sound like a Fun experience, but perhaps it helped clarify your valve decision?

It helped the doctors to see I needed the surgery sooner rather than later. The TAVR doctor wanted me to speak with a sergon about the on-x valve to be sure I understood the difference. Before that appointment I started researching the on-x valve, then read even more on the TAVR. The decision was mine and it was a tough decision to make! Both doctors and my heart team, said both would be a good choice for me.

 

[caro]

Hi! I did a stress echo. Lots of heavy wires, running up the highest incline. I finished it but the numbers made the surgeon think I needed surgery in few months. He mentioned ejection fraction numbers were pretty high.

 

[slipkid]

Hi! I did a stress echo. Lots of heavy wires, running up the highest incline. I finished it but the numbers made the surgeon think I needed surgery in few months. He mentioned ejection fraction numbers were pretty high.

If the fraction is HIGH then that is good. You want that to be as high as possible. I believe 50-60% is acceptable depending on your age (higher than 60% is good) but when you start dipping below 40 you are getting in trouble. Above 70% and you're probably an athelete!

I was only 33% when I collapsed and needed OHS (double bypass + AVR). Had difficulty catching my breath for months b4 I collapsed. Went up to like 55% after the OHS. Crept back down to around 40-something in next 5 years and needed a stent. After that got back up, over 60% (4get the exact #).

 

[caro]

@slipkid oh wow, ok good to know. Thank you. I’m looking at results now. My EF was normal. It was the peak and mean gradients that were too high. Says “as high as 151/89 mmhg” during stress echo.

Glad your EF is over 60% now.

 

[Critter]

I think if you can go 6 minutes on a standard treadmill it helps to decide if you can continue your waiting game before you get your valve replaced. If you can go 6 minutes without issues that is a good prognostication for the next 6 to 12 months.

 

[slipkid]

@slipkid oh wow, ok good to know. Thank you. I’m looking at results now. My EF was normal. It was the peak and mean gradients that were too high. Says “as high as 151/89 mmhg” during stress echo.

Glad your EF is over 60% now.

Thx.

Yeah the pressure gradients are a different story (I 4get now but there are some things they can supposedly tell from your echo like what the pressure is across your valve or aorta or in/out of the heart or something like that). And there is your blood pressure too like you mentioned. But I believe it is normal for that to go up during intensive exercise (?). I don't want to say the wrong thing.

 

[slipkid]

I think if you can go 6 minutes on a standard treadmill it helps to decide if you can continue your waiting game before you get your valve replaced. If you can go 6 minutes without issues that is a good prognostication for the next 6 to 12 months.

Something that pissed me off in each of my echo stress tests IIRC, that the summaries written for them all said something like "stopped because patient unable to continue". Which was totally untrue. I did everything they asked in every test and only stopped because they said they were done. But don't get me started - my last echo had all kinds of errors written in the report which I questioned to my primary doctor, which led to a lot of dodging, nonsense, and excuses by the cardiologist and the dr who produced that piece of garbage.

 

[caro]

@slipkid definitely. I think I could have put off surgery longer if I hadn’t felt drained in the days after my stress echo. The numbers were higher than normal and my AVA was .9. Surgeon I had at CC felt I should do surgery before symptoms. I may have been able to wait 6 months instead of 3 but the surgery was coming no matter what. I’m glad I had it done right before they cancelled a lot of scheduled procedures last March.

 

[Chuck C]

Had an exercise/ treadmill test today, was wondering if anyone else had had one of these on their valve journey prior to surgery?

And if so what results/ symptoms did you get during the test?

My blood pressure falls at peak exercise (I think below/ towards my baseline) which probably explains why I feel so rubbish at the top of a hill/incline!

I can see that in certain situations this is an indication for surgery in the guidance.

Would love to hear your experiences.

After my aortic stenosis diagnosis, my cardiologist had me complete a stress test and then a stress/echo a few weeks later. I did not present any symptoms on either. However, my cardiologist specifically indicated that one of the things that he was looking for was a drop in blood pressure with exertion, indicating this this is very serious. Per your post, it sounds like this occurred for you. Are they treating this as an indication for surgery?


Below is a comprehensive review of stress testing data on aortic stenosis patients. There is discussion about fall in blood pressure as an indicator of an abnormal stress test. Per the report linked, a fall in blood pressure is listed as a IIa indicator for SAVR in the AHA guidelines and a B indicator for SAVR per the ACC.
https://www.ahajournals.org/doi/full/10.1161/circulationaha.116.025457

 

[dwhist]

I have had issues with echo stress test. Three years ago doc asked me to do one to make sure no issues before another surgery due to diverticulitis. Valve replaced 7 years prior.

Went in for testing and woman doing echo part having issues seeing what she wanted. They ended up having another nurse put some stuff into my veins via an iv in back of hand. Did 11 minutes and they said enough. Two of the 3 nurses left room for a bit and came back and said ok for me to leave. They had left to confirm if ok with cardiologist on duty.

Next morning I get call from my cardiologists nurse. He is out of town but read report. I am to stop all exercising and if any chest pain call 911 or get to hospital ASAP. Of course I went ahead and did my biking. Following week he called me after returning from his vacation and wanted me to do an angiogram. He was going to have another cardiologist do it as he was busy. It was scheduled and I was told that I would need a stent at minimum possibly bypass, so to pack a bag for a few nights stay. This was based on echo test.

Went in for angiogram. They went in through wrist and the groin due to twisted arteries. Afterwards, doc came in and told me arteries were better than when last angiogram done 7 years prior and I was not going to have a heart attack. Fortunately my insurance paid all bills, otherwise I would have complained about unnecessary angiogram caused by flawed echo test.