Stress Testing Questions

[jerry1978]

Concerning Treadmill exercise stress testing:

1) Is it a fairly safe test for a person with no known heart disease, but with risk factors such as hypertension, anxiety, and panic disorder, like myself?

2)  If a cardiac event were to occur, would it occur at peak exercise, or would it happen during the recovery phase?

3)  My last test was in 2001, at age 41....test was negative, and I worked up to 10.1 METS on the Bruce protocol.....I understand that stress tests can determine blockages of 70 % and higher, but I was told by the tech. that I worked hard enough to determine that there was not even a 50 % blockage.....Does that sound correct?

4) I am on Toprol XL 25 mgs a day.....will I be instructed to stop it before testing?

Thanks-Jerry

[Cleveland Clinic]

jerry,

thanks for the post.

Good questions.  The bottom line is stress testing is generally very safe, but does carry some risk.

1) Yes.  The rule of stress testing is that there is always some chance of a false negative and false positive test. We expose people to the small risk of stress testing to avoid the higher risk of cardiac catheterization.

2) It could happen at either.

3) No.  It really is impossible to tell amounts of blockages externally.  We say 70% as a rule because there is some physiologic data to support it. However, I wouldnt be concerned with those numbers as part of a test. The most important thing is how long you exercise for.  It is predicitive of all cause mortality. What that means is if you are in better shape, as a rule you will live longer.

4) Most likely yes. It allows you to reach a higher heart rate.  There will be some instances where they ask you to keep it on, but for you they will probably ask you to hold your dose.

good luck

goo

[oakroom]

When I did my first stress test 3 weeks ago (I was having chest pressure and shortness of breath) I was barely on the treadmill 10 seconds when it starting going erratically up and down. Scared the technician silly. That afternoon they did a catherization and were shocked to find no blockage. Since then I've had normal Echo and MRI results. Am on 75mg of atenolol which seems to be helping - tho I seem to have more PVC's than I used to. The doctors are trying to avoid invasive procedures but 2 questions for anyone: 1) has anyone experienced VT on a stress test and had all normal other results - and how are you and 2)I'm emailing with clinical researcher on ARVD who says 2 red flags for me are my father's sudden cardiac death at 47 and my Italian heritage. I should pursue other testing. So does anyone have any comments or knowledge of ARVD and whether it's really something I need to think about. p.s. I'm a 45yr old woman. no high blood pressure, no high cholesterol - overweight but working on it - lost 30lbs over last 7 months. Probably need to lose another 15lb.

[Mantels]

I am onToprol XL  50mg and did the Bruce test for 20 minutes (actually 19:50) with HR at 184 BPM.

Had an MI 12 months ago.

The Toprol is tough, but you can train through it.

[Momto3]

During a few of my stress tests, I was on a beta blocker (Inderal) and it defintely made a difference on my recorded BP.  I completed the test, but my BP stayed real stable.  I think it may have topped at 110/70.  I couldn't tell the difference while I was walking on the treadmill, but the monitors revealed a different story.  The doctors said that my medicine was "doing its job!"  The report said that the BP response was "stunted" because beta blockers.

During a more recent stress test, I was not taking a beta blocker, but had been on a very low dose of an ACE inhibitor for about 6 weeks. This time, my BP and HR definitely responded to the increasing "stress" by going up as high as 166/?.  Guess that just shows how all meds work differently.

Good luck on your test!

connie