Use of chemical to increase heart rate for ultra sound

[reen1120]

My double bypass was in 1997 and now my cardiologist says after ten years we need to check for vein failure.  (The Mammry was used to bypass both blockages.)  I cannot get my heart rate up high enough the the test my Cardiologist wants me to have, so he will give me a new chemical test to increase the heart rate.  If I did have a weak graft, would this additonal stress cause me to have another heart attack?  How does the body react to this chemical.

Thanks for your answer.

[ed34]

Actually Jon, maybe you or someone can throw some light on what might have occurred after my angioplasty if I describe it and state what the cardiologists told me.
I was doing fine, laying in recovery and it was about 20 minutes after. Suddenly I felt a pain in my groin like I'd never felt before, it was like a knife was twisting in the incision site. I then felt sick and asked for a bowl and the nurse told me to start coughing, which I couldn't because I felt really sick. She layed me back and put an oxygen mask on me and called the Cardiologist in. His words were "This will be a good test for your heart" and then I heard the nurse say "220 and rising". The cardiologist injected me with something for the pain and I fell asleep.
When I had my outpatients appointment, I asked the cardiologist what exactly had happened and he said "When treated you, I made a small dissection in the LAD and stented it so it would heal. We think you had a faint due to a small bleed".
Now I'm not sure what they mean by a small bleed? out of my LAD into the sac surrounding the heart? surely not? I get the feeling I'm not hearing the whole truth here. My GP wrote to the Cardiologist 6 months ago requesting information about the episode but has heard nothing at all.

[ed34]

I had a chat with the cardiologist before the procedure started and gave her my concerns which were the mainly how my heart reacted after my angioplasty, and I was afraid it would trigger something off. She told the operators to increase the medication slowly and if anything strange whatsoever showed on the ecg, to immediately shut it off. She stayed in the room throughout the whole thing and although I was in agony with chest pains and throat discomfort, she didn't seem concerned by the ecg. When my heart rate reached about 110 I felt very nauseous and was given something which was supposed to counteract it, but by the time it took effect the procedure was all over. The whole ordeal was very uncomfortable for me, I felt like I'd had a heart attack and was glad to get out of there. I'm just annoyed it was all for nothing because nothing showed up and they keep trying to tell me there's nothing wrong with my heart now. How can that be when I had chest pains and throat discomfort during the procedure. So, I guess to answer your question, I think they just decided to be more careful with me due to the episode I had after my angioplasty, which nobody is still able to explain to me in detail what it was.

[erijon]

It's interesting that they started your drip gradually and built up you heart rate speed slowly, I never considered that may be necessary in some one with a history of CAD. Do you think that is why it was done gradually unlike my test where there turned it on like a switch?

Just curious, I never considered this aspect.

Jon

[ed34]

I had the same as Jon last month except it produced a lot of chest and throat discomfort for me, the exact symptoms I have been experiencing on exertion. However, that echo scan was performed because they couldn't see any problems with my blood vessels, so they hoped to see some abnormality in the anatomy of the heart or its function to explain my symptoms. Nothing was found. An echo is not the usual test to see the condition of blood vessels, that test is usually a ct scan/angiogram or nuclear perfusion scan. The only way to really see what's happening with coronary arteries is to image them. Even when my LAD was as narrow as cotton thread, every echo looked great.
The only difference between my test and Jons, is that they started the drip very slowly and gradually built it up. It was about 5 mins before my heart started to react and it gradually increased in rate, it didn't jump up quickly.

[erijon]

I can't comment about the way your graft will react, I don't think your cardiologist would chance it if there was a significant risk. I have had a chemically induced nuclear stress test due to a knee injury. It was really not what I expected. The moment they started the drip I immediately felt like I was running a marathon. My heart rate jumped up, I felt hot and was sweating and my breathing was labored. This lasted for 2 minutes to give them time to complete the test. Everything went back to normal immediately when they stopped the drip, it was amazing. I had no residual affects and felt just fine afterwards.

Hope this helps,

Jon