Dipyridamole Test

First I want to tell you again what a wonderful service to the public this is, it is truly a tremendous help.
I will try to keep this brief as possible.  Last week I underwent my 2nd Dip Tetro test in 3 years.  The first one i Had no side effects when the drug was administered.  This last time I had terrible side effects.  I had severe tightening in my chest and my arms went numb.  I was administerd the andidote and it in fact relieved my symptoms.
Cardiologist said ecg demonstrates signs of heart disease but have to wait for the pictures.  Since ecg is always abonormal to start with could be false positive.  I explained to the cardiologist that this is the same feeling I get on a day to day basis when my heart rate beats at high rates of 180 to 200.
My questions are as follows and I will list in order of importance so if you can only answer a couple that is fine. I should mention I'm on 100 mgs of atenonol for last 2 years now.
1)Will this dipyridamole injection give a healthy heart such side effects?
2)What is meant by an abnormal ecg?
3)Is there a correlation between fast heart rate and muscle weakness and numbness?
4)I've had 3 stress tests in 3 years, began with 1/3mm st depression I am not a 1mm st depression is this a significant increase or just very mild?
5)Echo shows mild mitral, pulmonic, and tricuspid incompetence does this have any bearing on what's happening?
6)I have had continual fast heart rate now on exersion for 3 years now, how long can the heart continue to beat at a fast rate before causing the body any damage?
7) 3 years ago I was 85 percent of maximum no medications, now 81 percent of maximum with meds.  Is this a good thing?
8) Do you have any experience with the drug prepulsid and do you know if any of these things could be attributed to that drug.  I was on them until the middle of January 2001.
Thank you so much for your time.

[CCF-M.D.-CRC]

Dear syd,

1)Will this dipyridamole injection give a healthy heart such side effects?
A: Dipyridamole causes dilation in normal arteries and no change or constriction in arteries with disease.  Therefore the segments of the heart that have disease will get less blood flow than the healthy parts. Dipyridamole by itself can cause symptoms of shortness of breath and flushing even in people with healthy hearts.   However, it also causes chest pain in persons with coronary artery disease.  The scans are usually read the same or next day so your doctor should have an answer soon as to which is the case in your situation.

     2)What is meant by an abnormal ecg?
A: Generally this refers to ST-segment elevation or depression but could indicate any number of ECG abnormalities.

     3)Is there a correlation between fast heart rate and muscle weakness and numbness?
A: If there is impaired blood flow to the muscles or the fast heart rate is accompanied by or due to anxiety it is possible they are related.

     4)I've had 3 stress tests in 3 years, began with 1/3mm st depression I am not a 1mm st depression is this a
     significant increase or just very mild?
A: Generally the cut-point for abnormal ST-segment depression is 1 mm but this must be interpreted in light of other ECG findings.


     5)Echo shows mild mitral, pulmonic, and tricuspid incompetence does this have any bearing on what's happening?
A: Mild regurgitation is in general benign.

     6)I have had continual fast heart rate now on exersion for 3 years now, how long can the heart continue to beat at
     a fast rate before causing the body any damage?
A: This would depend on the health of the heart.  In a young person without heart disease it could beat at 180 for days without damage.  In an elderly person with significant heart disease a rate of 180 for a short period could be harmful


     7) 3 years ago I was 85 percent of maximum no medications, now 81 percent of maximum with meds. Is this a
     good thing?
A: Probably just variation due to the medications.

     8) Do you have any experience with the drug prepulsid and do you know if any of these things could be attributed
     to that drug. I was on them until the middle of January 2001.
A: propulsid (cisapride) can cause harmful heart rhythm disturbances and interacts with many other medications but is not know to cause chest pain.

     Thank you so much for your time.