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Heart Disease (Expert Forum)
Heart Concerns
This forum is for questions and support regarding heart issues such as: Angina, Angioplasty, Arrhythmia, Bypass Surgery, Cardiomyopathy, Coronary Artery Disease, Defibrillator, Heart Attack, Heart Disease, High Blood Pressure, Mitral Valve, Pacemaker, PAD, Stenosis, Stress Tests
Heart Concerns
by MacyMaid, Aug 05, 2002 12:00AM
Doctor, last year I had Dobutermine Stress Echo (stressing heart without a thredmill)before knee surgery because I was having periodic chest pains that would appear out of the blue, the past 5 years, plus occasional PAC's (per a monitor)
Was told by Dobutermine Doctor that no ishemia was found and to have knee surgery. I saw the report 2 weeks later. It stated: Patient achieved 88% peak Heart Rate for age.(60 years old)
Study adequate. No Atropine used. No contrast agent used.
Peak Infusion was 30 mcg/kg/
Test terminated due to:
1. ECHO: LVOT Obstruction
2. Achieved Targeted Heart Rate
Also noted: Base EF 50-55% Low dose 55-60% Peak >60%. Recovery,
55-60%
If no Ishemia was found, why would they list LVOT Obstruction for stopping the test? The ordering doctor states this is a common gradient seen in most patients and is clinically insignificant.
The past 4 months, I have new symptoms. I now get short of breath and have almost constant pressure like pains in the chest (not as painful as the periodic chest pains that come out of the blue)
Recently had an EGD, MRCP/MRI, CT scan of abdomen. Shows slight reflux/small hiatal hernia. I feel no better since taking Nexium.
Am I overeacting to these pains? Should I accept this
as non heart related since DOB Doctor saw No Ischemia.
Should I be concerend about the LVOT Obstruction listed on the report as being a/CommonGradient?
How worthy is a Dobutemine Stress Echo? Would using a contrast
agent, been better? Is this test good for Cardiac Spams?
I need some closure to all this.
ThankYou, Doctor.
Was told by Dobutermine Doctor that no ishemia was found and to have knee surgery. I saw the report 2 weeks later. It stated: Patient achieved 88% peak Heart Rate for age.(60 years old)
Study adequate. No Atropine used. No contrast agent used.
Peak Infusion was 30 mcg/kg/
Test terminated due to:
1. ECHO: LVOT Obstruction
2. Achieved Targeted Heart Rate
Also noted: Base EF 50-55% Low dose 55-60% Peak >60%. Recovery,
55-60%
If no Ishemia was found, why would they list LVOT Obstruction for stopping the test? The ordering doctor states this is a common gradient seen in most patients and is clinically insignificant.
The past 4 months, I have new symptoms. I now get short of breath and have almost constant pressure like pains in the chest (not as painful as the periodic chest pains that come out of the blue)
Recently had an EGD, MRCP/MRI, CT scan of abdomen. Shows slight reflux/small hiatal hernia. I feel no better since taking Nexium.
Am I overeacting to these pains? Should I accept this
as non heart related since DOB Doctor saw No Ischemia.
Should I be concerend about the LVOT Obstruction listed on the report as being a/CommonGradient?
How worthy is a Dobutemine Stress Echo? Would using a contrast
agent, been better? Is this test good for Cardiac Spams?
I need some closure to all this.
ThankYou, Doctor.
Doctor's Answer
by CCF-M.D.-RCJ, Aug 05, 2002 12:00AM
MacyMaid,
Sorry to read of your troubles. The response (LVOT obstruction)that your heart had to the dobutamine is a normal variant and quite common in patients with normal hearts. Some echo technologists will stop tests for this finding once the max-predicted heart rate has reached 85% because some patients can have a low-blood pressure response to LVOT obstruction. Worry no more about this finding.
It is difficult for me to comment on the constant pressure like pains as they started some time after the dobutamine test. It sounds as if your doctors suspect a GI source of the pain given the tests that they have ordered, but I can neither reassure you nor alarm you with the limited information provided.
Hope that helps.
Sorry to read of your troubles. The response (LVOT obstruction)that your heart had to the dobutamine is a normal variant and quite common in patients with normal hearts. Some echo technologists will stop tests for this finding once the max-predicted heart rate has reached 85% because some patients can have a low-blood pressure response to LVOT obstruction. Worry no more about this finding.
It is difficult for me to comment on the constant pressure like pains as they started some time after the dobutamine test. It sounds as if your doctors suspect a GI source of the pain given the tests that they have ordered, but I can neither reassure you nor alarm you with the limited information provided.
Hope that helps.
I feel much better about the LVOT information. If I had only
been given this information (asked for) by the Cardiologist, I would not have had to ask you.
Thanks again and have a nice day.
P.S. I think a lot of doctors need to enroll in a course in how to talk to their patients in a meaningful and understandable manner. Fear is not healthy.
Thank You, again.
and calls patients with test results and is more conserative than agressive.One who also has years of expereincing with
stents.
Thanks.