I thought they’d tested me as much as they could and came to a diagnosis and treatment (I.e. no treatment left - meds exhausted and surgery not possible due to the particular anatomical nature of my myocardial bridge).
Out of the blue “ping” Apple Watch shows notification of an NHS appointment in late June 2023 for an Exercise Bike Stress Echocardiogram Test in London so means another expensive round trip.
It was mentioned when met surgeon in April (in London) but nothing said in their letter after. So come out of the blue.
Anyone who can share their experience of having had the test and how helped with their diagnosis / treatment although appreciate most will be for different heart issues, I’d very much like to hear from you.
Better see if I can find my trainers! And find out the cost of train tickets.
that’s a good point. I think my mind had resigned itself to start accepting situation so can start to move on as it were. But it’ll have to deal with the uncertainty / waiting again.
Will dig deep and drag out the “big and ugly me in big girl pants” and keep going🤪
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You have big girl pant, I have to put my big boy pants every day. Interesting that they want another test. Only have had a cpet test. Not one with an echo. I think they want more data especially when the heart is under stress. The echo will show some detail on flows and other stuff. I think they still want to look at more things to assist in further diagnosis. It is a worry and I appreciate your deep down feelings. On my next cpet my cardiologist want more effort. I suppose if it shows some improvements from last time, then she may change medication or look at other things. But considering I will have a cpet in a couple of months time and then she does not want see me until February. It does baffle the mind, but the mind keeps asking questions I carnt answer to calm it down.
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Hello
I guess as it’s my first they’re still wondering / scratching their heads like you say trying to get more data.
I can see why it would be baffling but it’s also good they are keeping eye on your, I’m sure she will see you sooner if anything of note on your test but in some ways hope she doesn’t want to see you as an indication the test is ok / no worse.
I don’t think we will find peace as such, but somehow work on how to manage the disquiet in our heads. Finding ways to distract if not answer might be all we can do to get a little peace for a bit!
❤️
in reply to
I think like someone said they need a base line to then see if things change. I suppose it's a bit like what happened to me. I had loads of test last year so the cardiologist has a picture of then. Now I suppose I will continue with checks every year or so, to see if there have been changes. Today iam on an anxiety course. So it's that battle with the mind that's the hardest. I don't think we will find peace but it's that word exceptance and living with it. A new way of living. Good luck on your test. Remember your big girl pant will get you through it All.
thank you, being honest I’ll look at the positive slant tomorrow and today I’ll wallow on the sofa and watch a few old movies, nothing like a bit of Cary grant and James Stewart to pick me up 😉
Hi. I had an echo stress test a few years back. Mine was on a treadmill. Basically, they took an echo before then had me running (hard) on the treadmill to really get my heart going. Won't lie, at the end when the treadmill was going fast and was at a steep incline I was really struggling and my heart was hammering. They then quickly took a second echo to see how your heart was performing under stress. Mine identified an abnormal heart beat that wasn't visible during the resting echo which, eventually, led to a double heart bypass so was worth doing in my case. Hope your test goes well.
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hi thanks for explaining, can’t say I’m looking forward to the exercise. My heart can thump like mad after walking up the stairs. 👍
I live with a long term condition with very few treatment options. At present I can't be 'fixed'
I haven't responded to the usual medication. I have had lots of different medications thrown my way.
In some cases there is every reason to carry out detailed testing, to be able monitor the progress of the person's heart disease. Without a baseline this can't be easily done.
Even though I have a confirmed diagnosis, my Cardiologist has sent me for tests including a stress echo.
We knew it wouldn't change my management however he wanted to know what my baseline was.
At some point I am sure I'll be sent for another cardiac perfusion MRI to check the condition of my heart muscle.
I have blood tests every few years for NTproBNP, echocardiograms and Holter tests, all to monitor the progress of my heart condition.
One thought, is it possible to have the stress echo test done at your local hospital or does Charing Cross offer a different more specific stress echo test?
The results will give the Cardiologist more information and even if there are few options at the moment, this may change in the future.
hi I’d really had assumed they just leave me alone eventually and tell me to come back if get worse symptoms but maybe they will monitor me too over time.
Interesting about the baseline, so could provide a basis for future monitoring against this - getting worse? And May just come up with something to help.
I need to research up Charing Cross in case have info on the test and I’d like to call them to understand the test and how long takes so tomorrow will do that.
Train tickets are relatively cheap but showing limited / only few available. So I’d have to make a decision soon about seeing if local hospital can do. Although I know the cardiologist will find it easier as Charing Cross is in same NHS trust. Might be all faster.
Although I’m whinging, I can see the positives bit clearer now and also another jolly to London.
I don't know if what I've had has been a "stress echo" test, but I have had stress tests done on an exercise bike about half a dozen times, mostly before and after rehab (have done it 4 times...don't ask!). It's hard! But reassuring that you're doing it in a lab hooked up to an ecg machine with a tech monitoring you.
Hidden As others have noted, they are looking for a number of indicators == from what I understand they want to see the heart rate smoothly ramp up and they will definitely stop the test if any dangerous anomalies show up, or you are in distress. On that note: If you are doing it and feel terrible, as opposed to tiredness, stop. The first time I did one I lasted just a few minutes before I had really bad chest pain -- within a week I was stented up!😐
I had an Exercise Bike Stress Echocardiogram to find out if I had microvascular dysfunction. I lasted only about two minutes before the cardiologist took me off the treadmill. They said the test was positive so I presume I have it. My latest cardiologist just brushed it off as no consequence but seemed to concentrate on the fact that my latest takotsubo episode had resolved.
hi have been trying to learn more about test, only thing I can find is something of a bike at the end of a bed combo!!!!
That’s very frustrating that you’ve had a positive result but it’s not being taken account of. So at the mercy of the variations in Cardiologist’s knowledge and training and what they each see as important.
Hi, I have one at least once a year to see how my heart performs under stress.They start slow walk on the flat for so many minutes ( think it was about every 4 mins) and then increase slightly and the incline and keep doing this. The cardio physios and consultant who is there whe I have mine have always been fab and say to say if any symptoms and keep a close eye and seem to know when they ve got enough.info so I ve only ever been on there for 12 or so.mins and then they monitor ou for a bit after. bhf.org.uk/informationsuppo... be honest having one just reassures me that they are monitoring me and I would feel more concerned if they didn't do it now and again as they are checking to see when I need valve replacement. Here is some info that might be helpful. bhf.org.uk/informationsuppo...
thank you for the link, I will certainly have a look. It’s a new day and I will try and focus on the fact they are keen to help if they can by doing another test.
I had thoughts this morning of me having to exercise for ages and them not picking up anything. I know I get chest pain etc on exertion. So hope I can last long enough for them to get what they need but hopefully doesn’t take long.
It’s definitely comforting for you to be monitored like that, living in the unknown is hard. Hopefully you’ll hold off the need for surgery for a long time to come.
Thank you and hope it all goes OK. I was surprised myself the first time that it was relatively short, there seemed to be more time just making sure that monitor leads were in place and the sitting around for a bit at the end to make sure all was OK.... take care.... let us know how it goes.
I had a cardiac stress test on a treadmill as part of my rehab assessment, but yours sounds more intense. All I would add is that I would see it as a positive an
Woops accidentally pressed send. It's a positive that they are doing further tests and looks like different treatment might be an option. They are not writing you off🙂. And you can't beat a bit of Jimmy Stewart any time.
thank you for the encouragement, starting to see the positive side it’s new sunny morning.
did google - nhs - patient info but for another hospital- apparently it can be a bike attached to the end of a bed so your half lying down 😁 sounds like a weird contraption.
Yes to jimmy - I feel bad I missed out Gregory Peck - Roman Holiday one of my all time favourites!
I think the sheer name of the test sends us into panic mode, but it’s honestly nothing to fear. You sit on a chair and cycle, you’re not actually on a bike. They inject you with some medicine and measure your heart reaction whilst you’re cycling. A nurse is with you all the time. You’ll be absolutely fine x
I’m not very fit and I did mine on a bike. You have lots of leads attached to you and you are constantly monitored. The consultant kept popping in and out so it’s perfectly safe. I was told I was fine except for my leaky mitral valve and ectopics which we knew about.
getting reassured with every reply. My text appointment says a bike. I just need to get through the next few weeks while I wait for appointment. Worst bit is waiting! Thanks for taking the time, very much appreciated. ❤️
Hi fishface, I'm from NZ, but I'm sure the testing is similar. (1) An exercise stress test (on a bike or a treadmill) is intended to get your heart working hard under work/stress.... cardiologists are interested in heart beat, ECG rythms, and blood pressure variations as you increase effort from rest to your maximum effort at fatigue - the last one I did I was told to aim to get my heart to 95% of age-predicted maximum (which is 220 bpm minus your age).... you might be told something else depending on your current fitness levels and diagnostic history. The treadmill ramps up speed and incline to make you work harder. Not sure how they do this on a bike, or whether bike isn't so forced in terms of increasing effort. Anyway, the "echo" bit adds another measure.... and involves extra equipment - so for this (2) essentially they ultrasound your heart to check for blood flow, ventricle contractions, valves, etc.... They do this before you start your exercise effort - i.e. at rest, and they do it again immediately after you've given your maximum effort to see what it's doing after being stressed. Of course, if they see anything adverse during the exercise effort (ECG, BP, etc..) they stop you going harder. I've had all these tests. Nothing to worry about, other than the effort you need to produce on the bike on the day. Good luck. Hope it reveals something they can usefully treat.
Just worked out my max at 95% out of curiosity and it’s 158 but on my angiogram in Jan 2023 they stopped at 145 (after injecting dobutamine) - it showed blood flow restriction at that rate and my heart was thumping so hard and my chest was the tightest it’s been. I shook so much afterwards.
I haven’t had an echocardiogram since April 2023 but that was just me lying still and them using that thingy they use to look at babies in the womb. It showed mild left ventricle hypertrophy hope it’s stayed mild.
I had a stress echo using a bike about 3 years ago at Harefield. I found it a bit difficult because I was lying back a bit and trying to pedal at the same time. You don't get the benefit of gravity when pushing down as you would when riding a bike in the normal position. When you are lying on your sofa have a go at trying to bicycle at the same time. The good thing is if you can't get to the heart rate they are looking for the doctor will introduce a drug to speed it up. It takes a while for the person doing the scan to build up the echo picture. The main thing I was told was not to stop suddenly but tell them when you can't go any further. The scan was very useful for me on my road to diagnosis as it showed "fairly global ischaemia". You know you're in trouble when the doctor says "I just need to go and have a word with the consultant."
So what I think you are saying if no benefit of gravity it will be harder and a true test of my heart? I’ll try the sofa cycling.
I do hope I do the test correctly now after the effort and expense of getting to the appointment I now starting to realise it may be a good thing to do. Thanks for the pointer on not stopping suddenly.
“Fairly global ischemia” sounds very scary. I’ll listen if they need to go and see consultant 🥴
Hi fishface 101. Don't worry about doing the test correctly. Everybody is there to help and get the best outcome for you. I found the bicycling a bit hard. The main thing is that the doctor will want to get your heart to it's maximum safe level. If you can't get there with the cycling they can give you a drug to increase your heart rate.
The bike bit was a slow and easy start that automatically got harder and harder. They told me to keep within the parameters which was difficult as I wanted to pedal faster at the start. They also said to go for as long as I could, I was getting lactic acid burn in my legs but my heart was ok so I kept going.
When I did eventually give up, they reduced the friction a bit and told me to keep going while they did the echocardiogram. This involved them pivoting the bike sideways and then scanning over my heart with the wand.
Don't worry, the bike has bars on the side to stop you falling off! But it is semi recumbent so you are half laying back.
Yes makes clearer in explanation, not quite visualising the recumbent bike / bed contraption. But have been on a normal recumbent bike in a gym many many moons ago.
Having read all these kind replies, I’m going to do my best to listen and do what they say, not stop suddenly and just keep going as much as I can.
I’m pretty sure these tests are expensive and lots of people waiting for them so I intend to do my bit/help doctor get what they need.
Apparently the request for the test was discussed at a “JJC” which I think translates my consultant and a bunch of others got together to decide should I have the test / is it needed. So more reason to make sure I engage with it because that’s someone else who doesn’t get a test and has to wait a bit longer. And they don’t do these tests on a whim so I must need it.
Thanks for explaining, much appreciated. As hoped posting and reading all the advice had put me in a better place than I was yesterday. I turned the air blue yesterday 🤭
You sound so much more positive today about the testing—I’m really happy for you being able to make that transition! I wish you the very best in your travel to and from the hospital and during testing and results.
I haven’t had that exact test so I can’t speak to the bike, but I believe that I had the same test—only with the nuclear material injection. The chemical is supposed to mimic the effect of exercise stress on your heart. You have pictures taken of your heart prior to the injection of the nuclear material—then injection and monitoring—then more pictures of your heart taken following stress. I was terrified to have this test done since it was about 2-3 weeks following my HA, but it honestly wasn’t as bad as I had expected. Plus, it did give more data about my heart.
Hopefully, you will feel that your upcoming test was not as bad as you feared. You have been given a lot of helpful tips and information from others on this site that will help. Again, I wish you the best with the test, and I hope that it gives you lots of useful information.
They were actually looking at heart functioning including ejection fraction. At least, those were the reported results. I had had a HA just 2-3 weeks prior so the focus was on damage to my heart, overall functioning, ejection fraction, and extent of blockages.
I’m glad that your brother will be able to drive you to your appointment. That should eliminate a lot of stress and provide support and comfort. Best wishes.
Your stress test will determine your treatment. They will find out how much oxygen is getting I to your and how well its pumping An expensive treatment medically but the Cardiologist will determine a lot from the analysis after Stay positive
thanks, interesting about the oxygen, I’m also completely separately being investigated for sleep apnea when I reported low blood oxygen readings on Apple Watch at night - GPs decision to refer - but it’s at a different hospital. Awaiting results of sleep study. 👍
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