Cardiolite exercise stress test and echocardiogram next week...

[Dee]

I am having a cardiolite stress test and echo done next week, the exercise portion one day and the echo and resting images a couple days later.  I have a couple of questions.  Is the test usually done by a doctor or by technicians?  If something is wrong on the exercise portion (treadmill) will it be detected right away?  If something is wrong, will I know right away or have to wait for the next doctor visit to find out?  I tend to have a good bit of chest pain with exercise and shortness of breath, will I be expected to work through the pain...I want to get the most valid test possible...if the pain is severe will they help me with it....although it usually resolves on its own with rest, it has occasionally lasted several hours and I don't relish the thought of repeating that kind of pain without relief again.  Finally, two questions regarding the dye...my father had an angiogram at age 45 (he died that same year but not from the test) and while they were doing it he had a horrible anaphylactic allergic
reaction to the dye used...he almost died (it was the next week he died in heart surgery).  I have never had an adverse reaction to any medicine, and they have not asked about family history of allergies to medications (my daughter has severe allergies to four medications, including anaphylactic reactions).  Should I mention this to the doctor when I go for the test, or is it enough that I don't appear to share their medication reactions?  Secondly, the instructions say after the test, to avoid close contact with chidren under the age of six for six hours....I teach preschool kids so am taking two whole days off work for these tests since they will use cardiolite both times.  What is the meaning about age six....why if a child is six would it be ok for me to be around them (and I could go to work) but if the kids are four or five, I have to stay away?
Sorry for so many questions...I think I am getting nervous.

[Cleveland Clinic, MD]

The test is usually done by a technician with a physician supervision.  How "close" the physician is depends on the level of risk for the patient.  Sometimes it will be standing next to the treadmill and oher times just in the vicinity.  Usually the results are not available right away but you can sometimes call and get a report the next day.  You will only be asked to exercise as you can and if you need to stop for pain that is OK.  No need to worry about your father's allergies.  It's probably a bit overcautious about avoiding children.  The radiation levels are very low.  I suspect this is more of a legal "CYA" clause than anything else.

[Dee]

Thank you!  I had the exercise portion of the test this morning...the technician did the blood pressures and the injection, and the doctor stayed right by me monitoring the machine the whole time.  I had no problems....Within seven minutes my heart rate was up to 180 beats per minute so my test was over very quickly.  He said I did good, and I heard him tell the nurse there was only a rare PVC.  It did take a good little while for my heart rate to come back down below 140, he said he was staying with me till it came down more, when it finally got below 120 (about 10+ minutes) he left, and I went to get the imaging done.  During the tests, NONE of the symptoms I have been experiencing occured....no chest pain, no palpitations, no shortness of breath....I tolerated the exercise exceedingly well. That is not necessarily uncommon, but what concerns me are the times when I do get short of breath, dizzy, nauseated, and experience chest pain with exercise...it always resolves with rest....during these times I have lots of skipped beats, which I realize are benign PVCs and nothing to worry about, but they do give me symptoms when they become very frequent.  One thing that no doubt helped today is I am healthier than I've been since August, my asthma has been under control for over a week now, and I finally have no sign of respiratory infection.  When I am ill I have lots more symptoms.  My heart rate does always go up fast...I did explain that I exercise to the rate I hit today quite often, and he told me he didn't think I should do that anymore....he said I shouldn't go over 155 bpm and he thinks going into the 170s to 180 during routine aerobic exercise is not wise.  Bottom line, I have 2 follow up questions....#1  will the exercise test be just as accurate even though I did not reproduce any of my recent symptoms, so that I know when they occur it is alright......and #2  As long as everything checks out ok on this test (Thursday is the resting portion and an echocardiogram), why not exercize past a 155 heart rate....it is VERY difficult to keep it below that point, anything more strenuous than walking mildly will push it right on up past 155 within a couple of minutes (including stairmaster, bicycles, crosstrainers,  swimming laps, playing basketball, running around with the kids, playing volleyball....all things I love to do).  I especially like the sports, and one of the reasons I was glad they wanted to do the tests was so I could continue playing even though my heart rate goes high and stays high for quite a while.  When it goes to 176-180 it is harder to continue the exertion, but at 165-175 I can continue for a long time.  Thanks.  (PS...I am 41 yr old female).

[Cleveland Clinic, MD]

I would wait until the images come back and the discuss these questions with your doctor in light of the findings.

[Dee]

I'm so sorry one last question please.  I just looked at my receipt from the cardiologists for the exercise stress testing etc, and for diagnosis it was marked:  Angina, stable.  I have never had this term applied to me....I thought angina implied some kind of serious heart condition associated with heart attacks?  I have had rhythm problems since 1984 when I suffered pericarditis....the pericarditis was cured but the arrhythmia remained, but was largely asymptomatic until recently.  PRevious diagnoses over the years have included:  pericarditis, cardiac arrhythmia, mitral valve prolapse, PVCs, and most recently atypical chest pain.  All pretty nonspecific benign things.  Does this new diagnosis represent a change from all these other previous findings?  What exactly does it mean?  And will having angina marked on an insurance claim make it more difficult for me to obtain life insurance in the future?  Thank you....I was surprised to see a different diagnosis than I ever have been before....I've never known
anyone with angina and only associate it with people that have to put a pill in their mouths to keep from having a heart attack.  Thanks for any clarifications.  Dee

[Cleveland Clinic, MD]

This is not so much a diagnosis as a "reason" for getting the test.  There are very limited "reasons" that can be used to order testing and have insurance pay for it.  Angina is one of them.  If the test is negative this will never be a diagnosis for you.

[Sandra]

I have been having chest pain.  My doctor performed a stress test yesterday.  No result back.  I am having pain in my right arm today no chest pain.  Should the pain in my arm be a concern?

[Sandra]

I have been having chest pain.  My doctor performed a stress test yesterday.  No result back.  I am having pain in my right arm today no chest pain.  Should the pain in my arm be a concern?

[LLOYD]

When having a stres done , what would be the protocol for stopping the test ?

[Jenmink]

A related discussion, Cardiolite stress test was started.