Stress bike echo test

[Kittyca]

Hello everybody, I have a question: could anybody advise if stress bike echo test reliable? I was in the queue for it (regarding possible PIP flecainide) and finally after waiting 3 months did it on the 4 August. My resting heart rate is rather low (49-54) before the test I had an episode of PAF which was rather strong , went to A&E and was given there 200 flecainide and 2,5 bisoprolol. Flecainide stopped my episode after 1.30 hours and bisoprolol I took just one minute before the episode stopped. I had terrible side effects of bisoprolol. My pulse went to 45 for the next 5 days but I didn’t want to miss the test and went (after 2 days of PAF episode). I told the nurse about it and she reassured me that I should continue with the test. I felt extremely uncomfortable during the test , what’s more have arthritis in both knees. Now I got the results which says that I have coronary heart disease and flecainide is forbidden. They prescribed dronedorone. I have read that the results of this test could appear false positive. Have anybody met the same problem? I am very stressed because flecainide helps me greatly: it stops episodes within 2 hours and without it they are about 36 hours. I would highly appreciate any advice…

[BobD Volunteer]

Difficult question Kittyica.

You say coronary heart disease but that really isn't very definitive. Flecainide is not suitable if there is any coronary artery disease. If that is what you mean then no you can't take it or it could cause serious problems. Although the stress test will show up some problems an angiogram is the gold standard to show how bad is (are) the blockage(s) in the coronary arteries allied to an echocardiogram to view the valve function and thickness of the various chamber walls etc.

[Kittyca in reply to BobD]

Thank you very much, Bob! Is angiogram dangerous? Who can give me a referral: go or cardiologist? NHS is overloaded now and it’s extremely difficult to find the right person. Do you think it might be reasonable to do it privately? I have also heard about mri perfusion test. Do you think it is the same but without radiation? Again, thank you so much

Kitty

[CDreamer in reply to Kittyca]

Angiogram is an invasive procedure so as with any procedure there is small risk but I wouldn’t have called it dangerous compared to not having it and not knowing the extent of any blockage. You would need to talk to your cardiologist but it would be considered a high priority, I would have thought.

It may be worth looking at a private option, that’s what my husband did and perfectly reasonable. Do you have private health insurance? Dependent upon what they find, could be expensive - privately angiogram from about £6K? My husband’s angiogram showed nothing, was a day procedure (he was 84 at the time) but it was worth it for the reassurance as he couldn’t proceed to any treatment for his persistent AF before having the angiogram.

It may well be worth booking a private consult with a good cardiologist just to ask those questions. You can always ask then to be put on the NHS list of your chosen cardiologist but do your research on who you choose.

You might also get some excellent pointers if you also post on the BHF forum as well as here.

Best wishes CD

[seasider18]

I had two stress tests that led to angiograms that were clear showing that they had been false positives. I was told that over 30% come into that category.

[Kittyca]

Thank you so much Seasider! I have thought about angiogram. Before performing stress bike test I had a choice between it and mri perfusion scan. Do you happen to know if mri gives more accurate results and it may be reasonable to do it before angiogram? Thank you very much!

[seasider18 in reply to Kittyca]

The one I had was not in an MRI scanner but similar a Nuclear Medicine Cardiac Stress Test (MIBI, DIPY Scan. It was also inconclusive.

ouh.nhs.uk/patient-guide/le...

[secondtry]

I would pay privately for whatever tests you need to confirm the position one way or another. It will be expensive but your 'health is your wealth' not your bank account.