Stress echo question

[Paleowoman]

I just saw my cardiologist to discuss some of the results of the last echo in February - still showing mild left ventricular hypertrophy which I never had before surgery, only developed it a few weeks post surgery. Cardiologist wants me to have a stress echo to see how my heart is during exercise instead of at rest. He said that when I have the echo the technician will decide with me whether to have it using a treadmill or with medication to speed up the heart. Does anyone know how they decide which a patient should have ?

 

[cldlhd]

Wish I could give you a better answer other than to say I had both. The medication one feels a bit weird. There was a moment or two when I felt like I couldn't breathe but they said that's normal.

 

[JulienDu]

I have done a few stress test since I was a kid but I never heard about being on medication to do one. I am also curious as to why they would put you on medication instead of the treadmill.

 

[cldlhd]

No idea, maybe it's more controlled? My heart rate didn't get any where near the predicted level which was good.

 

[JulienDu]

Ok that makes sense. Last stress I did post surgery, I read on the report they did that before the stress test they had :

-A Target HB
-A Max Predicted HB

So maybe as you said, going on medication stress test was to avoid going past the Max Predicted HB or just staying around the Target HB

 

[Paleowoman]

Thanks for your replies. I'm thinking now that they give a medication to raise heart rate to people who can't exercise on the treadmill or exercise bike - I'm fine to go on the treadmill and bike so will make sure they do it that way ! I won't be having this until mid May as I'm off on my hols in a couple of weeks to France so not worth doing till I come back.

 

[cldlhd]

They didn't give it to me because I'm not active. I may not have an 8 pack but I'm in pretty good shape. Perhaps my aneurysm gave them concern but I don't really see the difference in that regard as either way the heart rate and BP are elevated. The aneurysm doesn't know why. I think mine was called a "nuclear stress test".
Enjoy your holiday.

 

[Paleowoman]

Thanks cidlhd ! I will enjoy my holiday - tons of strenuous walking in the hills

 

[Seaton]

Bonsoir Paleogirl!

I’ve had two stress echo treadmill tolerance tests over the past six months, both times I failed to reach peak heart rate.

The first test last September I lasted 7½ minutes (I think they were aiming for 12) due to breathlessness and fatigue. The second stress echo test, in January this year, I managed 5 minutes, again due to worsening breathlessness and fatigue.

A confusing addition to the mix of my exercise tolerance is my over ten-year diagnosis of Chronic Fatigue Syndrome. So the fatigue and breathlessness may actually be caused by my general deconditioned state, or it may indeed be a symptom of worsening aortic stenosis, or perhaps a combination of both.

Either way, my consultant seems to want a clearer picture of what exactly my heart is doing under stress.

Consequently, instead of the need to exercise my heart by walking, a Dobutamine Stress Echo has been arranged to see what happens to my gradients (which are still low relative to my severe indexed aortic size) when my heart rate is increased incrementally to peak rate using a dobutamine infusion. My test is in a few weeks' time.

• “[A dobutamine stress echo] … produces high-quality images without the interference of deep breathing and muscle tremors caused by exercise.”​

• A Dobutamine Stress Echo (DSE) is a specialised ultrasound examination where a medication, (Dobutamine) is used to replicate the effect of exercise by increasing the heart rate. This test is recommended for patients who, for many different reasons, cannot walk on a treadmill.​

• http://www.rbht.nhs.uk/patients/condition/echocardiography/dobutamine-stress-echocardiogram/​

Give my love to France and the beautiful hills!

 

[cldlhd]

Bonsoir Paleogirl!

I’ve had two stress echo treadmill tolerance tests over the past six months, both times I failed to reach peak heart rate.

The first test last September I lasted 7½ minutes (I think they were aiming for 12) due to breathlessness and fatigue. The second stress echo test, in January this year, I managed 5 minutes, again due to worsening breathlessness and fatigue.

A confusing addition to the mix of my exercise tolerance is my over ten-year diagnosis of Chronic Fatigue Syndrome. So the fatigue and breathlessness may actually be caused by my general deconditioned state, or it may indeed be a symptom of worsening aortic stenosis, or perhaps a combination of both.

Either way, my consultant seems to want a clearer picture of what exactly my heart is doing under stress.

Consequently, instead of the need to exercise my heart by walking, a Dobutamine Stress Echo has been arranged to see what happens to my gradients (which are still low relative to my severe indexed aortic size) when my heart rate is increased incrementally to peak rate using a dobutamine infusion. My test is in a few weeks' time.

• “[A dobutamine stress echo] … produces high-quality images without the interference of deep breathing and muscle tremors caused by exercise.”​

• A Dobutamine Stress Echo (DSE) is a specialised ultrasound examination where a medication, (Dobutamine) is used to replicate the effect of exercise by increasing the heart rate. This test is recommended for patients who, for many different reasons, cannot walk on a treadmill.​

• http://www.rbht.nhs.uk/patients/condition/echocardiography/dobutamine-stress-echocardiogram/​

Give my love to France and the beautiful hills!

Thanks for the clarification Seaton. Paleogirl find me a nice Citroen HY Van with the right amount of patina...

 

[Paleowoman]

Yes, thanks for explaining the difference Seaton. I hope they find out exactly what's happening with your heart and valve when you have the dobutamine so that they can make some decisions. Your EOA is so tiny - is that real ?

I will give everyone's love to France and look out for that Citroen for cidlhd ! Two weeks tomorrow !