Re: Stress echocardiograms

Posted By CCF CARDIO MD - MTR on September 08, 1998 at 22:24:15:

In Reply to: Stress echocardiograms posted by Kristine on September 04, 1998 at 07:25:32:






Hello. Yesterday I had a stress echo and my doctor said my ekg looked fine with the exception of 3 PAC's. She said my echo images before and after excercise were also normal and my heart muscle is as strong as it can get. I was very pleased, but concerned about only one thing. During the stress part of the test she took my blood pressure several times and while my systolic pressure rose very well, my diastolic pressure never fell. I thought your diastolic pressure was supposed to fall. It remained around 80 even when I advanced to the more difficult stages of the treadmill (stages 3 and 4). I asked her about this (about whether this could indicate a coronary blockage) She said you don't judge the test from just that and everything else looked good. Is this true???  If you have good clean arteries, isn't your diastolic pressure supposed to fall upon vigorous exertion?  (meaning your arteries are opening up) I just want your opinion because I'd like to put this worry to rest and go on with my life. Also, are the 3 PAC's I had of any significance? She said they weren't. I have them everyday even when not exercising. Thank you.



  
Dear Kristine, thank you for your question.  The normal blood pressure response to vigorous exercise is for both your systolic and diastolic blood pressure to rise although the systolic pressure generally rises to a greater extent than the diastolic pressure.  Blood flow increases in all arteries during exercise so the arteries do "open up," but the diastolic pressure doesn't fall as a result.  Thus, I agree that you have a normal stress test.  The PAC's can occur with exercise or at rest and are a benign problem.  If PAC's bother you, then try to eliminate tobacco, caffeine, and alcohol and they may go away.  Good luck with exercising and I hope you can worry less about your heart now.
Information provided in the heart forum is for general purposes only.  Only your physician can provide specific diagnoses and therapies.  Please feel free to write back if you have more questions.