Is stress test ok with aortic aneurysm?

[Catie]

Hi. I'm back after remaining in the waiting room awhile. I didn't find a place here to reintroduce myself. I recently received a remote second opinion indicating that it's time to address my aortic aneurysm (4.9 cm at largest spot) and at the same time to get a new valve. I haven't decided on where to get the surgery and which valve yet.

My local cardiologist is balking at clearing me for a laporascopic ovarian cyst surgery, which I was hoping to complete ahead of the cardiac surgery. Got a new echo yesterday and now he wants another CT (3rd in 18 months) plus a nuclear stress test, since he says the valve is worse. I don't want all that radiation...

Does anyone know, is it okay to undergo a stress test when you've got an ascending aortic aneurysm that needs surgery? The exercise stress test last year raised my BP and I thought that's the very thing they tell you not to do with an aneurysm. Cleveland Clinic site leads me to think the exercise stress test and the aneurysm don't go together. Can't find anything on the chemical stress test with aneurysm.

 

[AZ Don]

When I was first diagnosed with an aortic aneurysm, one of the first things I looked into was exercising with an aortic aneurysm. I started a thread and included several links on this topic here: http://www.valvereplacement.org/for...2576-exercise-and-stress-with-aortic-aneurysm

Here is my summary:

It seems that intense exercise of any kind, even aerobic may carry some risks for those with aneurysms, though low level aerobic exercise is recommended. Emotional upset may carry similar or even greater risks. Everyone has to decide for themselves based on their specific condition, lifestyle, Dr. guidance, etc, but I think it is fair to say that those living with an aortic aneurysm should carefully consider their lifestyle and possible changes. It is my understanding that changes post-surgery may be required as well, though perhaps not as severe.

I've never had a stress test so I guess it all depends on how hard you are pushed during the test. I would think that anything more than moderate exertion would not be a good idea.

 

[Catie]

Thanks, AZ Don. I had read that thread some time ago and there's a lot of info in it; I can go over it again. I don't overdo exercise, though.

The exercise stress echo test pushes people to the point of exhaustion--they stop after X amount of minutes or when you can't go on any further--and it significantly elevates BP. I have taken that option off the table for now. I'm not clear on the chemical one. But it makes me lose confidence in my current cardiologist that he put me through that rigorous exam last year and wants another one now, when we already know I need surgery.

This from Cedars Sinai. Maybe this is my partial answer, but they use radiation and if it's not necessary I don't want the test. [h=4]I have a chronic descending aortic dissection. I have been scheduled to have an exercise stress test. I am worried about the effect that a stress test may have on my aorta. Is it safe?[/h] Generally an exercise stress test is not recommended for patients with aortic dissection or aortic aneurysm because of the potential of inducing hypertension, which can be harmful to the aorta. More appropriately, a drug-induced stress test can be used (adenosine thallium) which generally will not induce any hypertension.

 

[Paleowoman]

Why does your cardiologist want you to have a stress test ? Isn't he clear what's going on with your heart ? That is the usual reason. Here's a thread by Seaton on the chemical stress test: http://www.valvereplacement.org/for...issue-disorders/865558-dobutamine-stress-echo It sounds actually more 'stressful' than the exercise one.

I had an exercise stress techo test using a treadmill last month - I exercised till my heart rate went up to what they consider 100% maximum (165 bpm) - this was to check how my heart is functioning when I'm not at rest. I never had a stress echo prior to surgery as the regular echo showed clearly my bicuspid aortic valve and the high pressure gradient etc so there was no need to do a stress echo.

 

[Ultrarunner]

My ascending aorta is 4.8 cm. My cardiologist had no issues ordering a stress test. I gave up on level 6 out of 7. During that level my heart rate was 160 and my systolic was 160.

 

[Catie]

Thanks, Paleogirl and Ultrarunner.

I was wanting him to clear me for a laparoscopic ovarian surgery. He won't. Did a bit of research and now understand better why. He wanted additional tests in advance of that before considering clearing me because the valve worsened since December. I'm to get a new one in the near future anyway.

The Cedar Sinai position i cited on not doing the exercise stress test on aneurysm patients makes sense to me. And if I don't absolutely need the nuclear one, I don't want it.. I'm taking the ovarian surgery off the table for now. I think I can wait and defer to the cardio-thoracic surgeon's opinion about imaging when I see him.