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Heart Disease (Expert Forum)
Blood pressure DROPPED during nuclear stress test
Answered by
Cleveland - OH
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Blood pressure DROPPED during nuclear stress test
by starangel777, Jul 14, 2006 12:00AM
Hello,
I am a thirty year old female who has had a severe problem with irregular heartbeat, meaning skipping and going severly fast to the point where they hospitilized me twice for how bad it was.
I do likely have cushings disease so I have been told that may be what is causing this (almost triple the normal amount of cortisol). I am working on getting that fixed. In the meantime, thankfully they had me take 25 mg of Toprol XL daily (at night) to keep my heart under control. As long as I take it daily and not just when my heart goes nuts like I was told initially it does a good job keeping it steady.
I am not sure if I have atrial fibrillation and it says it on some of my medical records but when I ask my current doctor he doesn't answer. Needless to say, I am looking to change cardiologists, which brings me here to ask the following question.
They had me do a nuclear stress test and told me it came back fine. Yet when reading it I noticed that my blood pressure actually DROPPED during the test.
Here is what it says:
The patient exercised onthe treadmill for a total of 6 minutes, reaching stage 2 of the bruce protocol. HR was 72 beats a minute at baseline and increased to 164 bpm at peak, representing 91% of age predicted HR.
RESTING BP RESPONSE WAS 120/80 AND PEAK EXERCISE BP WAS 110/60
Rest LVEF - 54%
Stress LVEF - 66%.
Ventricle normal in size, no myocardial perfusion defects on resting first pace and gated planar views. Appropriate augmentation of the contractibility in all visualized segments on first pass images.
Why bp drop?
Thanks!
I am a thirty year old female who has had a severe problem with irregular heartbeat, meaning skipping and going severly fast to the point where they hospitilized me twice for how bad it was.
I do likely have cushings disease so I have been told that may be what is causing this (almost triple the normal amount of cortisol). I am working on getting that fixed. In the meantime, thankfully they had me take 25 mg of Toprol XL daily (at night) to keep my heart under control. As long as I take it daily and not just when my heart goes nuts like I was told initially it does a good job keeping it steady.
I am not sure if I have atrial fibrillation and it says it on some of my medical records but when I ask my current doctor he doesn't answer. Needless to say, I am looking to change cardiologists, which brings me here to ask the following question.
They had me do a nuclear stress test and told me it came back fine. Yet when reading it I noticed that my blood pressure actually DROPPED during the test.
Here is what it says:
The patient exercised onthe treadmill for a total of 6 minutes, reaching stage 2 of the bruce protocol. HR was 72 beats a minute at baseline and increased to 164 bpm at peak, representing 91% of age predicted HR.
RESTING BP RESPONSE WAS 120/80 AND PEAK EXERCISE BP WAS 110/60
Rest LVEF - 54%
Stress LVEF - 66%.
Ventricle normal in size, no myocardial perfusion defects on resting first pace and gated planar views. Appropriate augmentation of the contractibility in all visualized segments on first pass images.
Why bp drop?
Thanks!
Doctor's Answer
by Cleveland Clinic, Jul 14, 2006 12:00AM
, Jul 14, 2006 12:00AM
starangel,
I would be interested to see the rest of your cardiac workup. Normally blood pressure rises with exercise. In people with structural heart disease or CAD a decrease in blood pressure is a negative prognostic sign. Your normal perfusion images make the likelyhood of significant CAD unlikely. I would want to see an echocardiogram to make sure there was no other cardiac pathology. If not, I dont have a good explanation of the blood pressure drop, but the significance would not be that great.
good luck
I would be interested to see the rest of your cardiac workup. Normally blood pressure rises with exercise. In people with structural heart disease or CAD a decrease in blood pressure is a negative prognostic sign. Your normal perfusion images make the likelyhood of significant CAD unlikely. I would want to see an echocardiogram to make sure there was no other cardiac pathology. If not, I dont have a good explanation of the blood pressure drop, but the significance would not be that great.
good luck
Thanks for the reply doctor.
I did have two echocardiograms.
One said I had mitral valve prolapse, and a dilated left atrium and also that I had mild mild and tricuspid regurgitation.
I don't know if these are anything that would explain the drop in BP.
I have to say that it does concern me that my bp actually dropped.
I can tell you that WITHOUT the Toprol XL my heart is WILDLY irregular. SEVERE SEVERE skipping and fast.
What do you think- are the echo findings in any way explanatory for the drop in bp during the stress test.
By the way my father has coronary artery disease that he has stents in place to control.
Should I seek another cardiology opinion. I have to say I am NOT happy with my current cardiologist and I have NEVER seen him except for the first visit and instead they send in a nurse practioner.
Appreciate your opinion on this very much.
Thank you again,
starrangel