Stress Test

[cakesandbakes]

My cardiologist has requested a stress test for me. I spoke to cardiology nurse and I must say its filled me with fear. She said they inject substance into vein to stress heart. When I enquired as to risk she said it could induce an adverse event but will be monitored throughout. Surely there must be another way to see if stents and muscles are working apart from this or angiogram. Anyone had this test that can give advice please.

[MichaelJH Heart Star]

Are you talking about an ECG or echocardiogram based stress test?

[cakesandbakes in reply to MichaelJH]

I haven't recieved letter yet ,the only thing the nurse said (on phone) was it's not on a treadmill.

[Chappychap]

I'm confused, a Stress Test is an ECG that's conducted while the patient exercises, normally by walking on a treadmill that's progressively inclined to ramp up the work rate. As far as I know there's no injection involved.

There are other heart tests that do involve injecting fluids into the patient, for example an angiogram uses a dye and a Thallium Scan uses a minutely radio active substance to allow the scan to identify areas where the blood supply is poor or non-existent. But I've never heard these called Stress Tests?

[84green]

Hi

I had a stress echocardiogram which involved being wired to an ECG and blood pressure monitor and having an echocardiogram. I then walked on a treadmill which gradually increased in speed and incline (but still walking pace) until my heart rate reached it’s maximum rate. I then stopped exercising and had another echocardiogram.

The purpose is to see the effect of exercise (stress) on your heart. Changes in the two echos may indicate ischemia. No changes indicate that the blood is flowing through the arteries as it should.

Where physical exercise isn’t considered appropriate, patients can have a dobutamine stress echo in which a drug is injected that replicates the effect of exercise on the heart. Effectively, it raises the heart rate without the need for exercise.

A normal test means a very low percentage chance of heart attack in the next few years (I forget the figures). If problems are identified, it allows them to be identified and treated.

I haven’t had a DSE but they seem quite common and safe. I imagine it might feel a bit odd with the heart racing whilst you are lying still but they will talk you through the whole process. You will also be monitored closely throughout so in the unlikely event of an adverse reaction, it will be dealt with immediately. I found this link which might help -

rbht.nhs.uk/our-services/do...

Good luck and best wishes

[cakesandbakes in reply to 84green]

Thank you very helpful DSE sounds exactly what it is .Never heard of it before

[Chappychap in reply to 84green]

"Where physical exercise isn’t considered appropriate, patients can have a dobutamine stress echo in which a drug is injected that replicates the effect of exercise on the heart."

Excellent post!

[seasider18 in reply to Chappychap]

I had the drug but was also using an exercise tricycle. The result produced a false positive and I had to have an angiogram. Two previous treadmill tests were also false positives

[cakesandbakes]

Thank you all for prompt replies. You seem to have answered my question. Nurse said "Google it" I try whenever possible not to !!

[SouthernChelle]

I had a cardiac PET CT stress test just this morning. I had a treadmill stress test almost 3 weeks ago and based on inclusive results, the cardiologist recommended this test. It took about an hour total once they took me back. They started an IV and then took me into the imaging room and put me on the table. The hooked me up to a BP cuff and EKG. I had to have my arms over my head, but there was straps to hold onto and that made it pretty comfortable. They also put a wedge underneath my knees. The position wasn't bad at all. The platform went into the doughnut shaped machine and I had to hold my breath for a few seconds while they did some images. Then they came back in and put in the tracer material in my IV. I didn't feel a thing. I had to lay still (actually during the whole time I was told not to move from the original position) for about 10 minutes. They may or may not have been doing imaging during this time. Then they came back into the room and added the medication to simulate stress. I can't remember which medication they used. They warned me that I could feel my heart race, get a headache and/or feel short of breath. They told me that it wouldn't last long and it would just feel like I had ran up several flights of stairs. They talked me through it. I got a little short of breath but it wasn't terrible. I did get a pretty intense headache that I felt all the way from the top of my head into the back of my neck. The shortness of breath and increased heart rate lasted only a couple of minutes during which they checked on me about 3 times to get feedback on how I was feeling. About 5 minutes later, the test was over and they were pulling me out and unhooking me. They made sure I wasn't dizzy and had me sit on the side of the table for a minute and then they offered me a Coke (the caffeine is supposed to counteract the medication, and I was silly not to take it) which I declined and they walked me out.

I came home and got coffee in me (no caffeine for 24 hours prior to the test) but honestly the headache is lingering. It's not terrible, but it's there. I'm typing this 3 hours after they pulled the IV.

Now I get to wait on the results. 😜

They did tell me that different people react differently to the medication. Since I have medical anxiety and whitecoat hypertension I thought it would be horrible. I can say that it honestly wasn't bad at all for me. If I had to have it done again at some point, I would not stress about the test part of it at all. I'm in the states, so it may be done differently where you are. It definitely helped to have someone walk me through it. I hope this helps and best of luck!

[cakesandbakes in reply to SouthernChelle]

Thank you very informative

[shopman]

Have a read of this

bhf.org.uk/informationsuppo...

[cakesandbakes in reply to shopman]

Yes thank you. I'm sure it's as 84 green says likely a DSE test. I will know soon enough when invite arrives! !

[shopman]

Whichever one it is you will be fine. Like all things "heart" they sound worse than they actually are. After all you would worry about a pet at the vet or the car going in the garage.

[francesw47]

Hello cakesandbakes

I've had two treadmill stress test and two drug induced stress tests as part of an angiogram. I know of others who, for other reasons, have had a drug induced stress test as part of an echocardiogram. Others have described the treadmill or exercise stress test - which involves walking on a treadmill at a pace determined by the treadmill. The speed of the treadmill and the incline of the treadmill are increased at regular intervals to increase the workload of the heart under controlled conditions. You are wired to an ECG for the duration and immediately the cardiologist asks for the treadmill to stop you hop onto an examination couch and an echo is performed to look at heart function under conditions where heart is stressed (or working harder than normal). Stress is perhaps the wrong word to use! Other ways of conducting this test is to use a drug (in my case Adenosine was used) which speeds up the heart (same as if you exercised). Adenosine was injected via a canula (along with heparin, btw, in case of clotting) and all I felt was a slight flush. The cardiologist doing the angio wanted to see whether a small patch of atheroma was causing a blockage (it wasn't). It was all over in about a minute. My friend had an echo with stress involved - again Adenosine was drug used to speed up her heart and cardiologist could see effect of 'stress' on heart function.

Its really more worrying to think about it than to experience it! There are lots of reasons for wanting to look at how your heart works when under normal conditions or under slightly stressed conditions.

Good luck with it, and do let us know how you get on.

[cakesandbakes in reply to francesw47]

Thank you

[Elfmaiden]

I have had a stress echocardiogram and was carefully monitored throughout. The drug is administered in stages which they talk you through and your blood pressure will also be monitored throughout. Hopefully this is reassuring for you, please discuss any concerns with your cardiologist and best of luck for the test

[cakesandbakes in reply to Elfmaiden]

Thank you. Pretty much impossible to discuss with cardiologist. No face to face or vidio consultations and telephone appointment has to be requested through gp. Has remained like this sInce heart attack and stents 9 monhs ago.

[Alessa_]

Hi cakes, I was given a drug in the cath lab to induce some ectopics. It was very unpleasant, I kept being assured it was safe but it made my hands and neck seize up and my heart race. It is all controlled but by it's very nature, it sparks anxietyAll the best