heart

[crgildart]

stress tests.

IKR? Why is that all I think of are people I know who got sent straight to the hospital for emergency heart surgery stents when someone mentions a stress test??

 

[Sibhusky]

IKR? Why is that all I think of are people I know who got sent straight to the hospital for emergency heart surgery stents when someone mentions a stress test??

My husband had 2 different friends die as they walked in the door after one. When I did mine I finally proceeded to tell them I was stopping. I didn't give a¥¥√π about just one more number. Close enough.

 

[tball]

^^ Yikes. While it's just a number, a stress test is important in predicting life expectancy. The great thing is you can improve your number and life expectancy through exercise.

Your ‘Estimated Age’ From a Stress Test Is a Better Predictor of How Long You’ll Live Than Your Actual Age

A new Cleveland Clinic study found exercise performance is a better predictor of how long you’ll live than your chronological age.

health.clevelandclinic.org

How long do YOU have left to live?

The test, created by cardiologists at Johns Hopkins University in Maryland, involves running in three-minute segments on a treadmill with an increasing speed and at a growing incline.

www.dailymail.co.uk

 

[Jerez]

Nuclear stress test? My DH found out the hard way that a "regular" stress test isn't all that accurate. Nuclear version saved his life.

 

[Sibhusky]

give a¥¥√π about just one more number. Close enough.

While it's just a number,

Maybe I wasn't clear. There was some target number they wanted me to get to and after 20 minutes I was one digit below that. I was on medication that helped keep my heart rate low, no one told me not to take it. I was exhausted. I told them I was stopping. And I'll never do another one of those damn things. I'm almost 71 and do not plan to have to run anywhere.

 

[Sibhusky]

Nuclear stress test? My DH found out the hard way that a "regular" stress test isn't all that accurate. Nuclear version saved his life.

I'm pretty sure I had a regular one. How do they differ?

 

[crgildart]

I do enough yard work and walking around on weekends to probably be mostly OK for a 20 minute jog. But, I can always blame my back back or bad toe if I feel like I need to tap out. I've gotten legit dizzy a couple times in the past 5 years doing physical exertion type stuff. I've definitely lost some cardiopulmonary performance beyond what I thought I'd lose in my 50s. Let's say I was killin it in my 40s (no pun intended). At age 30 I weighted 150 and benched 225. But the loss of performance in my 50s has been exponentially worse than the loss of performance in my 40s. I'm now up to 185 pounds and can't do three pull ups. I definitely want to be sure that it's just age and activity decline related and not some major defect that has me on the edge of a widowmaker. I realize they might find something significant and that scares me. But, I still think the odds are higher that I'm just getting old, fat, and lazy,,

 

[no edge]

Nuclear stress test? My DH found out the hard way that a "regular" stress test isn't all that accurate. Nuclear version saved his life.

I get the Nuclear version stress test and the stress is induced by chemical. Dr told me that I had to do a better job than that - or maybe I lacked ambition. I was surprised that I couldn't do the test without chemical motivation. I'm 68 so it is possible that I am considered to be too old. (I'm not too old.) Being out of shape is probably part of the problem.

 

[Paul Lutes]

Yeah, it's bad enough that we have to age, but to make it an accelerating aging is just mean.

 

[Jerez]

I'm pretty sure I had a regular one. How do they differ?

I am not sure. But the cardiologist said it's much more accurate. Gold standard. DH had a regular one with a good report. A few months later, prepping for back surgery, he ordered the nuclear one as an afterthought "just in case." He had a complete blockage of his LAD (the widowmaker). 48 hours later he had a stent inserted and is doing great. They took him off the Plavix and declared him good to go. All the rest of the heart is clear. Like I said. Saved his life.

 

[crgildart]

I am not sure. But the cardiologist said it's much more accurate. Gold standard. DH had a regular one with a good report. A few months later, prepping for back surgery, he ordered the nuclear one as an afterthought "just in case." He had a complete blockage of his LAD (the widowmaker). 48 hours later he had a stent inserted and is doing great. They took him off the Plavix and declared him good to go. All the rest of the heart is clear. Like I said. Saved his life.

Surely he had some symptoms that concerned him enough to revisit that diagnosis. Did he? If I were having the dizzy episodes more often (twice in the past 5 years I can recall) beyond just feeling a little winded after hiking up vert I'd also not be good with them saying the stress test shows no issues. If I were sincerely trying to get in much better shape and facing headwalls beyond expectations I'd definitely take a deeper dive to find out more..

 

[Jerez]

Surely he had some symptoms that concerned him enough to revisit that diagnosis. Did he? If I were having the dizzy episodes more often (twice in the past 5 years I can recall) beyond just feeling a little winded after hiking up vert I'd also not be good with them saying the stress test shows no issues. If I were sincerely trying to get in much better shape and facing headwalls beyond expectations I'd definitely take a deeper dive to find out more..

No. He had no symptoms at all. He is in his 70s so the surgeon wanted a pass from a cardiologist before agreeing to do his back surgery. That was the only reason he went so soon after an annual checkup, when he had the normal stress test. The cardiologist said it all looked good and was about to give him the A-OK when, as we were getting our coats on to leave he must have had some intuition and said "Let's do a nuclear stress test just in case we missed something." By the time my DH drove home after the test the cardiologist was already calling him to schedule the cath lab. He really truly saved his life!

 

[Jerez]

PS... that was last Thanksgiving, so it is now an even bigger holiday for us!

 

[tball]

Here's what I understand about stress tests after having a nuclear myself and being with my Dad as he did several of each kind.

I'm aware of two options: 1) chemical or exercise, and 2) nuclear or non-nuclear.

During an exercise stress test, you get on a treadmill and work at increasing workloads to get your heart up to a prescribed level. If you cannot reach the desired heart rate for whatever reason, they give you medicine (chemical) that artificially raises your heart rate. They may decide to skip the treadmill and just do the chemical if you are frail, have arthritis, or shouldn't do the treadmill for some reason.

For a nuclear stress test, they inject radioactive material into you when you are near your target heart rate (either by exercise or medicine). Then they image your heart with a PET scan to see how well blood is flowing to your heart and to find any blockages. With a non-nuclear or "regular" stress test, they don't do imaging. Throughout both, they monitor your ECG, blood pressure, and 02.

Based on my experience and the stories above, I'd push for a nuclear stress test if possible. Better to be sent to the cath lab for a stent to fix a blockage found by the nuclear stress test than sent home not knowing about the blockage.

 

[crgildart]

Just scheduled mine for next Thursday afternoon. "ECHO Stress Test" is what the appointment says. They were pretty matter of fact about it acting like it's no big deal.. Said I'd be back to work in an hour or so. No food for 3 hours prior, no water for one hour prior.
We'll see how it goes.. I don't have any meetings scheduled after it. Blocked out the rest of the work day. Will get the chest x-ray tomorrow. Urgent care shouldn't be too busy early tomorrow.

 

[tball]

I forgot about the echo stress test. My dad had one of those too. The nice thing is it can be done in the cardiologist's office, unlike needing to go to the mothership for a nuclear stress test.

I believe an echo stress test adds an echocardiogram "echo" both before and after a regular stress test. An echocardiogram is a sonogram of your heart (like is done for babies in the womb) and uses doppler to measure the blood flow.

Knowing the results will be great if you haven't had an echo yet. It will tell you how well your heart is pumping (LVEF), if there are any issues with your valves, and possibly identify other structural issues with your heart.

An echo tells how well blood is flowing through your heart. Unfortunately, it doesn't identify how well blood is flowing to your heart, ie, do you have any blockages due to coronary artery disease?

The stress test and echo combo will give you a great idea of how well your heart is working.

You might inquire how they will assess your extent of coronary artery disease, as your heart can be pumping great with clogged arteries that put you at risk of a heart attack.

 

[tball]

I should add a little update on my recent heart rebuild. My new aortic valve is working great. I had an echo a couple of weeks ago, and my docs are super happy.

It's amazing the amount of info they get from a non-invasive echocardiogram:

++++++++++++++++++++++++
+Interpretation Summary+
++++++++++++++++++++++++
Left ventricular function is within normal limits. LVEF 70%. There is abnormal septal
motion consistent with post-operative state. The left ventricle is normal in size. The
left ventricle is normal in thickness.
The right ventricle is mildly dilated. Normal right ventricular systolic function.
The right atrium is mildly dilated.
25mm St Jude Regent Aortic valve, well seated with trivial, normal aortic insufficiency,
mean gradient 6 mmHg, peak velocity 1.7 m/sec. Normal valve appearance and hemodynamics
The aortic root is normal. The proximal ascending aorta is normal in size.
Right ventricular systolic pressure is normal. The inferior vena cava is normal in size
with respiratory collapse, indicating a right atrial pressure of approximately 3 mmHg.
Prior TTE was pre-operative; AVR now presnt, LV much smaller at this point, aortic graft
has been placed., less MR now seen.

Procedure:
Two patient identifiers were confirmed prior to performing this exam. A
complete transthoracic echocardiogram was performed (2D, M-mode, Spectral and Color Flow
Doppler imaging). The patient was bradycardic during the exam with a heart rate below 60
bpm.

Surgical History/Intervention(s):
25mm St. Jude mechanical valve 6/1/2022.

 

[no edge]

I guess I should add a little update on my recent heart and aorta rebuild. My new valve is working great. I had an echo a couple of weeks ago, and my docs are super happy.

It's amazing the amount of info they get from a non-invasive echocardiogram:

++++++++++++++++++++++++
+Interpretation Summary+
++++++++++++++++++++++++
Left ventricular function is within normal limits. LVEF 70%. There is abnormal septal
motion consistent with post-operative state. The left ventricle is normal in size. The
left ventricle is normal in thickness.
The right ventricle is mildly dilated. Normal right ventricular systolic function.
The right atrium is mildly dilated.
25mm St Jude Regent Aortic valve, well seated with trivial, normal aortic insufficiency,
mean gradient 6 mmHg, peak velocity 1.7 m/sec. Normal valve appearance and hemodynamics
The aortic root is normal. The proximal ascending aorta is normal in size.
Right ventricular systolic pressure is normal. The inferior vena cava is normal in size
with respiratory collapse, indicating a right atrial pressure of approximately 3 mmHg.
Prior TTE was pre-operative; AVR now presnt, LV much smaller at this point, aortic graft
has been placed., less MR now seen.

Procedure:
Two patient identifiers were confirmed prior to performing this exam. A
complete transthoracic echocardiogram was performed (2D, M-mode, Spectral and Color Flow
Doppler imaging). The patient was bradycardic during the exam with a heart rate below 60
bpm.

Surgical History/Intervention(s):
25mm St. Jude mechanical valve 6/1/2022.

That's great news. Wish you all the best.

 

[no edge]

I am going tomorrow to meet with my Cardiologist. Let's see what he's got in store for me now. I am going to push for a reprieve. They are going to make me start working out in their gym - they won't be impressed by my efforts. Maybe an open mind would help. I am getting tired of all these new meds and the procedures and all of the disruption it causes to my fun.

 

[Lorenzzo]

I should add a little update on my recent heart rebuild. My new aortic valve is working great. I had an echo a couple of weeks ago, and my docs are super happy.

It's amazing the amount of info they get from a non-invasive echocardiogram:

++++++++++++++++++++++++
+Interpretation Summary+
++++++++++++++++++++++++
Left ventricular function is within normal limits. LVEF 70%. There is abnormal septal
motion consistent with post-operative state. The left ventricle is normal in size. The
left ventricle is normal in thickness.
The right ventricle is mildly dilated. Normal right ventricular systolic function.
The right atrium is mildly dilated.
25mm St Jude Regent Aortic valve, well seated with trivial, normal aortic insufficiency,
mean gradient 6 mmHg, peak velocity 1.7 m/sec. Normal valve appearance and hemodynamics
The aortic root is normal. The proximal ascending aorta is normal in size.
Right ventricular systolic pressure is normal. The inferior vena cava is normal in size
with respiratory collapse, indicating a right atrial pressure of approximately 3 mmHg.
Prior TTE was pre-operative; AVR now presnt, LV much smaller at this point, aortic graft
has been placed., less MR now seen.

Procedure:
Two patient identifiers were confirmed prior to performing this exam. A
complete transthoracic echocardiogram was performed (2D, M-mode, Spectral and Color Flow
Doppler imaging). The patient was bradycardic during the exam with a heart rate below 60
bpm.

Surgical History/Intervention(s):
25mm St. Jude mechanical valve 6/1/2022.

Just awesome to hear T. You must be thrilled.