Stress Echo Interpretation

[paola37]

After posting last week "test interpreation" I received an add'l result. Your comments are appreciated.

Treadmill for stress Echocardiogram
Current Rx: Toprol 25mg qd. Physical examination: bp 122/82 with hr of 64. Ekg: 12 leads ekg reveal normal sinus rhythm. This is essentially normal EKG.

Stress Test
Method: Bruce protocol
Result/Symptoms: The patient exercised for 9 minutes, achieving 10 MET. The test was terminated due to dyspnea and fatique. No chest pain symptoms. Reached a peak hr of 166, which is 91% of her age predicted max, peak bp of 154/88 with double product 25.5.

EKG. There is no ischemic ECG changes. No complex tachy or bradyarrhythmias. However, there were occasional to frequent PVC near peak excercise.  

Stress Echocardiogram Report:
Baseline echo: resting images show normal chamber size & normal ventricular wall thickness. LV systolic function is normal. RV systolic function normal. Slight thickening of mitral valve leafltes (should I be concerned about this? What is it and what does it mean?) No evidence of MVP. Trace mitral regurgitation. Trace to mild tricuspid regurgiation (Why these traces -what are they and what do they mean?). No Pulmonary hypertention by doppler.

Post-exercise Echocargiogramm:
Results: Following maximum stress excerice - no wall motion abnormalities developed.
Interpretation: Normal LV Systolic function w/no echocardiographic evidence of stress-induce ischemia. No significant abnormalities.

General Question:
Why does my EKG always show minor ST changes - what are they?  Regards, Paola37

[arthur]

I have a resting HR of about 40-45.  I am an amateur athlete and have been at that HR for most of my life (I am now 54).  My EKG typically warns that I have first degree heart block and bradycardia ... duh ... these findings are normal for athletic hearts, not so normal for people not in athletic condition.

Working out will send the HR to about 120; if I really push hard (like in a stress test), I can get it up to about 150-160.  Recovery is usually to 50's within 1-2 hours.  

When first diagnosed 2.5 years ago with PACs and some PVCs (and PAF which was successfully ablated), I had lots of anxiety and felt my heart thumping all over the place and felt light-headed quite often.  Now that I understand what it's all about, I hardly notice the heart anymore, and have learned to live with the occassional skip.

Hope this helps put things into perspective.

[paola37]

Hi Hankstar - good to hear from you again. Thank you for your reassuring comments. After the stress echo results the doctor suggested to start running again.  I have started my excercise routine again  -I am up to 3 miles/day and lifting weights.  I am feeling better but I sure feel those pvc's - I do try to ignore them but it is so difficult - Today I excercised  particularly hard - I said to my self "Either those pvc's will kill me or I will kill them... let's see who win... I finished my 3 miles in less than 27 minutes and I felt good --- I want more than everything else for things to get back to normal and for my heart to do what it is supposed to do w/out making "noises".
How is the weather in the Cayman Islands :-)?
Regards, Paola

[BillyboyAA]

Does anyone else in here have a very slow resting heart rate.  I have a rate of 44 right now as I am typing this.  When I workout at the gym it gets to between 100-120.  It also recovers very quickly.  My cardiologist says this is very good and all of my working out in the last 3-4 years is paying off, that I have the "heart of an athlete."  I get very scared when I get a heart rate that is so low.  My Holter results last year confirmed sinus bradycardia, sinus arrhythmia, about 144 "late beats"  (which my doc says are due to the slow rhythm, there are longer pauses inbetween beats.)  My rate during sleep was 33.  That really concerned me.  It is hard to tell if I have symptoms due to this slow rate or not.  I have it while resting throughout the day.  Could this be Sick Sinus Syndrome??  I am a very fit 32 year old male, 5'9" 155# lean and toned.  My doctor thinks my light-headedness and my headaches and weird breathing are due to anxiety and stress over worrying about this.  I am a panic/anxiety sufferer too.  Any words of wisdom in this area are welcomed.  Thanx for letting me ramble on forever.  :-)
Thanx and take care, Billyboy.  ***@****

[CCF-M.D.-CRC]

1)Slight thickening of mitral valve leafltes (should I be concerned about this? What is it and what does it mean?)
A: It means the mitral heart valve has some slight thickening which is normal with age.  This is within normal limits and is not something to be concerned about.  

2) No evidence of MVP. Trace mitral regurgitation. Trace to mild tricuspid regurgiation (Why these traces -what are they and what do they mean?)
A: Regurgitation is backwards leaking of blood across a valve.  Trace amounts are normal and nothing to worry about.

3)Why does my EKG always show minor ST changes - what are they?
A: Minor ST changes can be due to many different things but most likely in your case is just the way your heart is put together.  Again, these changes are within normal limits and are nothing to worry about.