Unresolved Question

[KimC]

Hi, everyone.

For those of you who have been there before, I need your insights.

During my hospital stay a few weeks ago, I had a Thallium Stress Test and felt pretty good on the treadmill, in fact, I was joking with the cardio and nurse.

But around the third or fourth incline, I started to feel unusually fatigued. As the test progressed, I felt breathing pressure and told the cardio that if I were at home, I would quit or slow down. He pushed me onto the next level, and as I began jogging uphill faster and faster, all of the sudden, I felt incredible chest tightness and they stopped the test, ran my stats and sat me down. This was the first time that I'd ever experienced anything like it.

Looking at my discharge notes, the radiologist said that he could not detect any signs of loss in systolic function, although my left ventricle continues to be mildly dilated and the regurg is still there.

My primary care doc says that he's skeptical of the internist's notes on my discharge record -- the internist said that he could not explain the incident, and theorized that I probably had exercise-induced asthma or an anxiety attack, but I did not hyperventilate and my EKG did not show signs of fast arrythmia.

A week later, I tested positive for asthma and was put on a steriod inhaler and bronchodialator.

I'm left with not-knowing the significance of the incidence on the treadmill. I was told by my vascular surgeon to be alert for symptoms such as reduced exercise tolerance or SOB upon heavy exertion, as a sign of my heart weakening.

Sorry to be so long-winded, but if anyone out there has ever experienced what I described above on the treadmill or elsewhere, then I'd sure love to hear your description of your experience. Not to be morbid, but did you huff and puff or feel like an elephant was sitting on your chest? I see my PCP tomorrow and plan to have a list of questions ready.

I refuse to believe the incident was anxiety-related, but who knows. The mind is a powerful thing, and I was in a hospital with a gazillion cardios around.

I'm also reluctant to call my surgeon and report the incident because this was the first time it happened.

Thoughts anyone? Anyone been there?

Thanks again,

 

[MarciaB]

I have had several treadmills, but have not experienced a sudden pain like you discribed. I know that they always pushed me harder than I would push myself, and I always did OK on them according to my cardio. The last one 2 months before surgery he said I wasn't too bad for someone my age, and a lot of women would be in that range, if they were overweight and out of shape. Two months later he was sprinting to the phone to call the surgeon after a cath. I always told him that I hated the treadmill, but he didn't seem to understand why. The cath showed that my valve got really sloppy while exercising, but they couldn't tell that from the treadmill. I think maybe something is going on, but is not showing up in the tests you are doing. The anxiety-related stuff is a bunch of baloney, I think they say that when they should be saying, "we don't know".

 

[Georgia]

I don't know anything about your results, but . . .

Seems to me that the cardios et. al seem to leap to "anxiety" or "stress" when women are involved. Anyone else here feel a little paranoid about this like me?

When I was in the hospital for chf, before I had my cardiac cath, my doc gave me ativan "in case your symptoms are from anxiety or stress" - can you imagine? I couldn't breathe lying down and they thought maybe it was anxiety-related?

Hmph.

 

[Nancy]

It's not just women.

When Joe went to the ER with severe CHF (right before he almost died from Class IV CHF and had to spend a month in another hospital getting straightened out), in comes the "shrink" intern to ask a lot of questions. Anyone with a stethescope and a pair of eyes could have determined that CHF was the problem, not anxiety. Anxiety could have come from not treating the CHF correctly, however. Not being able to breathe can cause you to be panicky. Maybe at that point the little intern should have been interviewing me. He'd of gotten an earful!

I don't know, sometimes, I just don't know.

 

[Harpoon]

The intern was probably "practicing" and should have been supervised during the interview by someone who knew what the hell they were doing.

But then again, maybe the intern got ripped to shreds afterwards by his supervisorupon learning that he gave an initial psych eval to a patient with CHF....


I've experienced sensations like that but generally from over-excertion. My last experience on the treadmill didn't have a "sudden onset" but it was there right before they stopped the treadmill.


How long did it persist after you stopped exercising?

 

[KimC]

I felt the pressure building as I hit the treadmill harder. Like I said, I told the cardio that if I were at home, I'd quit or slow down. Then when he pushed me to the next level and I felt exhaustion, I felt my airways close up and yes, I probably panicked, too. They sat me down, I caught my breath almost immediately on my own, and was given a cup of 7up.

 

[medtronic of borg]

Drs

Drs

Remember the fact you may have several dx at the same time. The medical Dr. has his The nurses have theirs and the each type of Dr. you will see may have one. It gives a pretty clear overall image of the pt , and in the case of the nurses what needs to be done.

The heavyness is what I think you need to firmly bring up with him.

Med

 

[KimC]

Interesting, Med. I never thought of it that way.

I will bring up the heaviness.

Best,

 

[ALCapshaw2]

Kim,

Were they able to get a good set of pictures after the exercise?

Did they take another set of 'resting' pictures?

"Heaviness' could be a symptom of coronary artery cutoff due to a blockage, either plaque or sometimes a 'spasm' resulting from the exercise. Such a blockage 'should' show up if they got good pictures.

OR, it could be something else. That's what the Doc's get paid the 'big bucks' to figure out

'AL'

 

[Harpoon]

I guess it should be pointed out that the whole point of doing a stress test (as dangerous as it might be in some instances) is to push your body to it's upper limits....


They want to know where those limits are. They want to know just how hard your body can work, what it's upper tolerances are for exercize.

They have a good picture of what a heart healthy person's average limits are in a stresss test and they compare that to what you're able to do. That gives them a basis for judging how "competent" your heart is and what's going on when it's not working at optimum performance.

There are other tests that tell them how the heart functions, the stress test tells them how the body copes with that function. How much oxygen you're sucking in and how much you're pushing out tells them about your cardio-pulminary efficency, monitoring pulse-ox in your finger tells them how much oxygen is getting out into the body. The EKG I think is more for watching your heart under stress and making sure it's not "too" under stress, like in heart attack region....

There's a variety of things they're looking for in a stress test and it's important to push you that hard so they know just where your heart is, what it can truly take and how well (or not) it performs.

 

[KimC]

Thanks Al and Harpoon.

My doc about fell off his red leather-back chair when he called the lab and heard how high my TSH level is: 11. (He said normal is 1.0). This means my thyroid has essentially shut down. Not a good thing for many organs, especially the old ticker.

Could anyone out there shed some light again on hypothyroidism? I know I'm essentially asking the wrong group of people, but am completely clueless on this one.

More tests, more docs and more opinions to come, I'm sure. I'm glad I'm not working ... but at least I have a diagnosis.

Kim

 

[ALCapshaw2]

Sorry to hear about your new problem Kim but glad you have a diagnosis. That's the first step in getting it fixed.

Just to be on the safe side, it might be a good idea to repeat the test or otherwise verify the result before undergoing anything drastic!

Best wishes,

'AL'

 

[KimC]

AL,

Yes, I repeated the test yesterday, and will continue to do so as pregnancy can cause transient thyroiditis.

I promise not to get my thyroid removed just yet. Although it probably wouldn't matter!

Thank you,

 

[Harpoon]

I had that.... Hypothyroidism, or maybe it was hyperthyroidism...

I think the hypo one.


My thyroid shut down, along with a few other rather important organs like the kidneys, when I got into the stage iv CHF... No one knew it until I got into the hospital for my surgery.


I was on a medication called synthroid for the whole time I was in the hospital and about three weeks after I got home (that's close to three months) and things are back to normal now.

I don't know much about what was going on wiht the thyroid, just that it kinda shut down along with a few other things because the heart failure got so bad. I guess once that got under control the thyroid came back, with some assistance of the meds.