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Heart Disease (Expert Forum)
Reaction during, and aftermath of a Dobutamine Stress Test
This forum is for questions and support regarding heart issues such as: Angina, Angioplasty, Arrhythmia, Bypass Surgery, Cardiomyopathy, Coronary Artery Disease, Defibrillator, Heart Attack, Heart Disease, High Blood Pressure, Mitral Valve Prolapse, Pacemaker, PAD, Stenosis, Stress Tests.
Reaction during, and aftermath of a Dobutamine Stress Test
by OneWabbit, Aug 17, 2002 12:00AM
I had a Dobutamine Stress Test 3.5 wks ago. I was told to take my medications the morning of the test (Altace, Welbutrin, Zantac, and Clariten-D, Oxycontin). I have asthma.
The report states, "The maximum heart rate attained was 147 beats per minute with a maximum blood pressure of 121/60." I was then given two mg of Inderal at which time I started to feel an enormous pain and extreme pressure in the center of my chest traveling down the right side of my chest. It was so acute that tears flowed out of my eyes for 20 mins without a sound.
The report states, “three minutes into the recovery phase the patient began experiencing chest discomfort that was persistent. Echocardiogram at that time revealed hyperkinesis of all areas of the myocardium with LVOT gradient of approximately 20mmHg. At that time the patient was given the third mg of Inderal. There was no evidence of Doubutamine induced ischemia, and no evidence of ischemic heart disease, but evidence of Dobutamine induced LVOT gradient of 20 mmHg." The cardiologist told me my heart was perfect.
Pains have persisted, not at the same level ever since. 2 wks ago they started on my left side, down the left arm, up my throat around my jaw & lasted 8 days constantly. I went to the ER. I have since had a Cardiac Cath & a lung scan which were normal. I am told we might never know what is causing my pains or they are my chest wall.
I was walking 2 miles/day prior to the test, and feeling wonderful, now I am in a nightmare. The info I have been given does not sound logical since it all started in the test. Help?
The report states, "The maximum heart rate attained was 147 beats per minute with a maximum blood pressure of 121/60." I was then given two mg of Inderal at which time I started to feel an enormous pain and extreme pressure in the center of my chest traveling down the right side of my chest. It was so acute that tears flowed out of my eyes for 20 mins without a sound.
The report states, “three minutes into the recovery phase the patient began experiencing chest discomfort that was persistent. Echocardiogram at that time revealed hyperkinesis of all areas of the myocardium with LVOT gradient of approximately 20mmHg. At that time the patient was given the third mg of Inderal. There was no evidence of Doubutamine induced ischemia, and no evidence of ischemic heart disease, but evidence of Dobutamine induced LVOT gradient of 20 mmHg." The cardiologist told me my heart was perfect.
Pains have persisted, not at the same level ever since. 2 wks ago they started on my left side, down the left arm, up my throat around my jaw & lasted 8 days constantly. I went to the ER. I have since had a Cardiac Cath & a lung scan which were normal. I am told we might never know what is causing my pains or they are my chest wall.
I was walking 2 miles/day prior to the test, and feeling wonderful, now I am in a nightmare. The info I have been given does not sound logical since it all started in the test. Help?
Doctor's Answer
by CCF-M.D.-RCJ, Aug 17, 2002 12:00AM
OneWabbit,
What a bizarre story. The only thing possible reaction that could possibly tie this together is persistent bronchospasm (the cause of asthma) from the inderal. Unless the pains are severe, I would try to not let anxiety create a "nightmare" from this reaction. The good news is that your heart is fine.
Inderal (propranolol) is a very frequently given medication. I have never heard of such a reaction. One way to verify or refute that propranolol caused the pain would be to receive the medication again in a monitored setting with your cardiologist. At least then you would know if the pain was just coincidental or really caused by the medication. It sounds from what you've said that you have not suffered permanent bodily harm from the pain, which would make repeat administration of the inderal safe. Alternatively, you could see your internist for a methacholine bronchospasm challenge to see if you are in the midst of an asthma flair.
One last possibility is that you suffer from coronary spasms, but I have never heard of these being produced by inderal. The cardiologist should have seen spasm during the cath, however.
One last thought, cocaine users can have paradoxical reactions to inderal. I'm assuming that you have not used cocaine.
Hope that helps and good luck.
What a bizarre story. The only thing possible reaction that could possibly tie this together is persistent bronchospasm (the cause of asthma) from the inderal. Unless the pains are severe, I would try to not let anxiety create a "nightmare" from this reaction. The good news is that your heart is fine.
Inderal (propranolol) is a very frequently given medication. I have never heard of such a reaction. One way to verify or refute that propranolol caused the pain would be to receive the medication again in a monitored setting with your cardiologist. At least then you would know if the pain was just coincidental or really caused by the medication. It sounds from what you've said that you have not suffered permanent bodily harm from the pain, which would make repeat administration of the inderal safe. Alternatively, you could see your internist for a methacholine bronchospasm challenge to see if you are in the midst of an asthma flair.
One last possibility is that you suffer from coronary spasms, but I have never heard of these being produced by inderal. The cardiologist should have seen spasm during the cath, however.
One last thought, cocaine users can have paradoxical reactions to inderal. I'm assuming that you have not used cocaine.
Hope that helps and good luck.
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The nightmare I referred to is that I am 3 months post-op a lower back fusion surgery, and I had recovered enough to walk 2 miles a day. I felt like I was on my way to a new life. Since the new pains have continued ever since the test, thankfully not as severe as the first 2 weeks, I have been unable to return to my walking. Mainly out of concern that it would retrigger the severe pains. This past few days it has even affected my cough varient asthma which has been under control for years. Walking is considered to be an essential part of my recovery and helps the bone growth of the fusion.
Can someone please tell me what "LVOT" stands for, and what "LVOT gradient of approximately 20mmHg" means? I can not find a definition in the medical dictionaries or web sites I have checked.
Something you said in your reply has given me a plan. My plan is to treat the effects at this point as anxiety, and ask the doctors to prescribe some Ativan. Any symptoms from that point on we will just have to deal with on an individual basis, because I am going back to my walking, slowly of course, and to my new life.
Thanks again,
dld