Cardio Stress Test

I am 82 and have had a PM for three years to maintain heart from going "below" 60 and fainting.   When I have annual PM checks, I ask the corporate rep to turnoff or raise level to 80 to check heart is working on its own to stay at 60. So far it has.  I am active, mountain hike and power race...more.

I have always taken stress tests for my cardilogist on treadmill prior to PM. I have one scheduled and he ordered the chemical induced test rather than the treadmill? He said it was the PM. I am not happy with chemicals being put in me to stress the heart. My question is : If the PM is not concerned with the heart going "above" 60 which is the whole purpose of a stress test to get it higher, why preclude the treadmill?  Before I address this paradox, at least to me, thought others may have faced the same scenario?

Thanks.


8 Comments

cardio stress test

by new to pace.... - 2022-04-05 06:35:12

I have  also had the  chemical drug test.  As my knees would not hold up  on the tread mill.  I am not fond of the use of drugs in my body.  But this was does not bother me.

new to pace

chemically induced stress test

by Gemita - 2022-04-05 07:38:22

MTHiker,

Firstly, I am impressed with your level of activity and how well you sound. Only your doctor can tell you why it will be more beneficial for you to have a chemically induced stress test rather than a treadmill test in the absence of any symptoms, although I see you have a history of heart disease.

A chemically induced stress test is often used for those who are unable to get their heart rates up safely to levels that your doctor needs to see, to assess for heart problems, for example coronary artery disease and any critical blockages needing immediate intervention.  

My husband (almost 83) received a chemically induced stress test to help confirm his degree of arterial blockage which was quickly followed up by an angiogram and three stents, two of which were needed to unblock his LAD artery.  In his case he would have been unable to reach the target heart rate “safely” by treadmill.  We were also told that with a chemically induced stress test they would have more control of both his heart rate and any symptoms he might suffer during the procedure.  After the test my husband was kept under close observation for about an hour and then was able to return home.  He suffered no ill effects.   My husband needed the test to look at blood flow to his heart muscle and to help confirm ischaemia as a cause for his chest pain and breathlessness.

Are you able to increase your heart rate effectively to the level needed for your activities?  Perhaps your doctor wants to observe you under “controlled conditions”, where they can increase your heart rate safely, to determine the appropriate settings for you with your history of heart disease?  

Stress test

by Julros - 2022-04-05 10:32:49

What are your concerns about "chemicals" being injected? Are you concerned about toxic effects, potential to cause cancer, or long-term effects?  The two substances commonly used, Lexiscan, and a radioisotope are much less toxic that say a CT with dye. They are both eliminated quickly from the body, and this type of scan gives very precise information about what part of the heart muscle may have decreased blood flow. 

Chemical stress tests are often used in the setting of pacemakers because a paced beat may not show if there is decreased blood flow, or ischemia. A paced beat resembles a left bundle branch block with a chronic elevation of the ST segment, which is the part of the ECG examined for ischemia. So if your ST segments are already elevated, it is difficult to detect a change whilst undergoing a treadmill. 

Stress test

by AgentX86 - 2022-04-05 13:00:07

I'm scheduled for a stress test in June.  I asked how it worked since my heart rate is under complete control of  my PM (PM dependent).  AIUI, the point of a stress test  isn't to see how fast the heart beats. Rather, the purpose is pump a lot of blood to see the flow through the heart at higher than usual output.  This higher output gives some margin to see how the heart functions before it gets so bad that it doesn't. Getting it to pump faster is one way but opening the blood vessels, dropping BP, also works. This doesn't increase the rate but increases the stroke, accompishing the same thing. The test is done in a controlled environment rather than in the street, where the outcome won't be so good.

I'm not looking forward to it but the street is hard and the big sleep is long.

 

Chemical Induced Stress Test

by MtHiker - 2022-04-05 14:37:09

Thank you all for informative comments. Still hoping there may be someone with PM for same reason as mine, to keep heart from going below 60, who will comment. The cardiology office called and postponed the test with scheduling problems? Will have more time to evaluate the change from the treadmill.

Two weeks ago, I was rehabbing a knee injury and working with a physical therapist. He had one exercise where I pushed an industrial metal cart, the type that weighs hundreds of lbs with steel wheels the length of the exercise room, about 20 yards and back, ttwice with him yelling to go faster.  Just winded after the masochist was done. The blood was flowing under stress!! I had two stents about 20 years ago and the Watchman about 5 years back for Afib. I just question whether the stress test is on the schedule for this year and being done because of time or need? Yes, I may die of cardiac event after writing this, but the 82 year old body is saying,  do you really need a stress test to measure blood flow?  Especially one using chemicals? 
 

Again, thanks to all.

Why Now?

by Julros - 2022-04-05 14:57:37

I suppose only your doctor can answer why he is advising you have a stress test now, especially if you are symptom-free. As far as I know, you can refuse to be tested, but be sure you understand all the risks and benefits. From what you have posted, I am guessing you have not been provided with that information. 

I have second degree HB. My underlying heart rate is 30 without my pacemaker, which is set to pace at 70 beats per minute. I have a strong family history of early onset heart disease. All of my grandparents died before age 65, my dad had his first heart attack at age 50. 

 I was unable to complete a treadmill test prior to my pacer due to slow heart rate, and I had the chemical one. I much prefer that to running braless on a treadmill wearing only a hospital gown, panties and shoes. It was over in about an hour and the cardiologist had unequivocal results. 

Bradycardia

by AgentX86 - 2022-04-05 20:33:41

In one way or another we all have a pacemaker to keep our heart from falling below some limit.  That's what they do.  The reason the HR may fall below some number may differ but that's really all pacemakers do.

Physical therapists are masochists.  That's why they went into the profession. ;-)

You should have been told if yoor doctor thinks there is a problem or if it's proactive.  You you and doctor should have much better communication. He should tell you exactly why he's doing everything he's doing.  You are signing consent forms.  How can you consent to something that you don't understand?

I'm not sure why you're scared of "chemicals".  Everything is a "chemical". The drugs used wash out of the system very quickly. Of course nothing is without risk, including ignoring your cardiologist.

chemical

by dwelch - 2022-05-04 01:42:24

because my upper limit was below what they wanted to push me to, that meant physical.  the only thing that bothered me was the continous lack of communciation. Oh you have a pacer (after the , bring your shorts and walking shoes, etc).  and what is your limit, okay we have to ocnsult with the cardioligst on staff today....we are doing the chemical one.   something they could have figured out well before I got there, at the time of teh appointment almost.

it was no problem, get the shot, here is 10 bucks go get breakfast on us at the cafeteria we want some food in you, comeback in a while, okay, monitor for a few, done, go home.

 

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You can hear your heartbeat in your cell phone.

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