Stress Test

[my3reasonsy]

Since Jan 06 have had chest pain, sqeezing & burning, occassional sob only during exercise.  I have exercised 4-5 days wk for 2 years+. In Jan had thallium stress test, ecg, echo, ekg, holtor, ekg and ct scan to rule out stomach.  Stress test stopped after 9 min. due to reaching max heart rate of 151.  Bp was normal.  Holtor showed heart rate at 195, 20 minutes into workout-with pain episode. Tried numerous meds to control hrt rate-atenolol, verapamil and now on toprol xl 50mg daily + baby asprin.  My bp now fluctuates between normal 106/66-150/86 at rest.  Don't know what it is during exercise. Cardio dx me with "Stress Induced Hypertension & Tachycardia".  Says he normally sees this in a few women in teens & 20's.  I'm 38.  Goes away in about 5 yrs. Last wk during my spin class had no pain, but felt odd. 20 min. into class, instructor checked my pulse-10 beats normal, speed up, and stop-repeating for 2 min. Rate only 83 in very intense class.  Normally about 130 now with the toprol. Has happened twice now. Still have some pain episodes.  Will wear holtor again Monday.  I know the hm shows the heart rates but would another stress test done at least 20 minutes be appropriate to ask for?  I may or may not have an episode, but if so, would it be more likely to show what is causing the pain if it is the heart?  The toprol is lowering my heart rate, but I still have pain and now these bottoming out sensations, do you have any ideas on what else could be happening? No other times, just during workouts.  Thank you for any input you may have.

[Cleveland Clinic]

3 reasons,

thanks for the post.

I would get an event monitor so you can wear it longer and hopefully capture the event. A heart rate of 195 is on the higher side, but could probably be achieved in a intense workout in a young person.

I would have to see the holter monitor/rhythm strips to really tell if anything was truly abnormal.

sorry i cant be of more help.

good luck

[my3reasonsy]

Thank you for your answers.  I am just a bit concerned that even with the toprol my pain episodes are still continuing, although not as frequent and also that I'm having such odd pulse rates(high then plummiting) during my workouts. Hopefully I will show the pattern on my holtor.  I was just curious if a stress test run until an episode occured would show what is happening to my heart at that time.  Although from what I have read, a st is usually run until patient reaches the max heart rate, which for me was 9 minutes.  I am almost certain I would have had a pain episode if the st was run for approximately 20 minutes, as that is the typical time it takes for me to feel pain. Thanks again for your information.

[my3reasonsy]

Thank you for your comments.  Sorry you have been through so much. How are you doing now? As for me, I am concerned that the stress test was only run until I reached my max heart rate.  That was 9 minutes and my pain does not happen until at least 20 minutes into my workouts.  I thought if they would run a st until I have an episode, I could find out exactly what is going on with my heart.  The toprol does seem to bring my hr down, but I still experience pain on occassion and now these strange very fast hr and then dropping so quickly.  I hope the holtor will help my cardiologist figure out what is going on.  If not I guess there will be further testing.  Thanks again and hope you are doing well.

[NurseKagome]

What were your risk factors before all of this happened @27yrs of age? Like obesity? Heart Disease? Any previous signs? Familiy history? Sorry if thats too personal and you don't wanna answer, I'm just curious because you were so young to have had blockages. Feel free to NOT answer...haha :) It just sounds like you have been through a lot. Take care!

Nurse Kagome

[NurseKagome]

I feel so crapy about feeling sorry for myself when I hear all that you have been through at such an early age...here I am having bursts of nasty palps left right and center and feeling like **** about it...and you, really suffering with a threatening family history.

How do you cope with these things? The fact that you have something "wrong" with your heart? I feel fearful, strong on days too, but fearful alot to the point where it can be debilitating to my life.

I'm 23 and I fear death on a regular basis, regarding my heart. I have seen a psychiatrist and he was greatly helpful but haven't seen him since march, so I am going back to old ways I guess. In my head it's SO REAL but reality may be different. I plan on seeing him again in September.

I hope you do good with your situation, live a long life and get the procedure you want to help you live life fuller! :) I am so much wimpier than you...your tough!

Thanks for writing and ttyl!

Nurse Kagome :)

[my3reasonsy]

Just an update.  I wore the holter monitor yesterday and turned it in this morning.  Of course, no episode happened while wearing it, but the nurse said it could still possibly show what is going on.  If it doesn't, then I will probably wear a 30 day event monitor.  I just think it is very odd that these pain/plummiting heart rate episodes don't happen everytime I workout.  When they dothey are pretty scarey.  I sure hope to find out what is happening and soon!

Al Dente, I also have a lot of cardiac issues within my family.  On both sides, I have heart disease, hypertension, stroke, thyroid problems, cancer and probably anything else you can name.  Mostly things happen after age 50.  Oh, just thought I'd mention, my mother is from Germany.  Well, you keep pushing your cardiologist to get things taken care of, so you can have a wonderful future.  Take care of yourself!