Stress ECG and symptoms

[Smiley2000]

Hi everyone.

Short history: I am female, 37 and had mitral valve repair done during 2008. High family cholesterol.

I had a stress ECG and echo done a week ago. I needed to get this done as we are applying for Permanent Residence in Australia. I did not mention any symptoms that I've been having or had during the test because I do not want to complicate matters and need a report that says my heart is fine!

Echo: mitral incompetence, but normal after the type of surgery I've had. Before the operation I was in total heart
failure, pulmonary hypertension and bad shape and I am confident that mitral op was a success and Cardio agreed.

But now I need to ask you: I did 8 minutes on the treadmill and then I asked to stop.  I did not feel well during the test, but did not mention anything.  My BP at the beginning of the test: 100/70 and heart rate 73.  At the end of test: BP 140/90 and heart rate about 143 b.p.m.  That all sounds normal to me, so I would say I had a normal stress ECG? except for the fact that my legs felt rubbery and I had to really push myself to do the 8 mins.

When I do small tasks around the house (house cleaning) and climb stairs I get shortness of breath and palpitations and my leg muscles feels weak. I walk the dog every morning and afternoon (500m trips) and then I am fine, but I can not run short distances (not even 10m) or I feel weak, shortness of breath, palpitations and dizzy and legs rubbery.  So playing with my dog and kids is exhausting.

Is this normal?

If there was something wrong, would the tests have picked up anything, without me having to mention symptoms I've been having?

[airpup]

I don't have much expertise regarding the modifications of the heart but can tell you that I feel much of your symtpoms and have for a few weeks now. I'm 27 years old and have worked out/eaten health for most of my life but am befuddled by all of my recent cardiovascular/neurological issues. I had a 24 hour holter and stress echo done a year ago, both which were normal. These tests didn't solve my symptoms but did rule out heart issues. Fast forward to now and I'm getting pvcs/palpitations, something I've never had before and have to get my tests redone. The doctor said your heart can change within a year if you have a fever of the heart occur. To sum my post up, I'm in better heart health than you are and have many of your symptoms, so it may not be something all that bad to worry about, rather just difficult to deal with.

[Smiley2000]

Thanks Jerry!

I'll have to come and live in the USA one day as the 4th of July is also my birthday :)

I am taking it easy now and keeping a low profile until our PR has been confirmed.  I'll also try and get to a gym or do a bit more exercise than just walking the dog.

Keep in touch and enjoy your weekend :)

[Jerry_NJ]

Great, being young helps healing a lot, as it should.  That could account for your rhythm issues resolving, your heart being young enough to "shrink" back toward its original/intended size.

It sounds like your heart surgery was a complete success and the type repair is considered permanent.  I know the echocardiogram can "see" the mitral valve ring, it sees mine, but it seems that is not an issue for full admission to Australia.  

I believe the "cardo rehab" is more about people who suffer a heart attack, but then maybe you were in that range -have you been told about any heart muscle damage?  

I also believe it is never too late to get in condition (speaking of course to the living), but again the objective in a stress test is to run the exercise at a level that stresses the heart, elevates its rate.  Thus a power runner is hard to stress test on a treadmill.  The rest of us just walking at 4 mph on a steep grade will get our hearts up to maximum.  

The nuclear stress test I took about 6 months ago was done without the benefit of my beta blocker.  I was told not to take it in the morning of the test so it wouldn't make it difficult to get my HR up to maximum.  It turns out I forgot to take my BB the night before too, so I had nothing holding my Afib driven HR down.  So I was just walking on the treadmill when my HR hit the goal, 135 for an old guy, so they immediately injected the nuclear fluid and I got off the treadmill after just a couple of minutes.

Sending my best wishes for your family and a Happy USA 4th of July.  This is a great country too.  But, I can say  the one few day business trip I had to Melbourne and the many kind/friendly Australian colleagues I worked with mostly in Geneva and Europe, leaves a warm spot in my heart for Australia.

[Smiley2000]

Hi there,

Thank you for dropping by :)  I used to talk to you on the ENT Forum.  I unfortunately have some unresolved issues there to.

I had a congenital defect on the segments that supported the mitral valve leaflets.  The Thoracic Surgeon cut away some bad segments and a ring was sutured on to ensure that the leaflets close properly.  The medical Insurance I had at the time of the surgery went under liquidation and I could not get any cardio rehab or real support post-op.  Maybe that is why I have a limited exercise tolerance?  I sometimes wonder.

Yip, Australian Immigration is strict on health issues due to the Medicare system.  Which is great and I am all for it, but it is hectic at this stage.  I have 2 healthy kids and hubby is also very healthy and they have never had any health issues.  I don't want anything to delay our application.

I had pulmonary hypertention pre-op but I am sure that is normal now as ECG and Echo did not pick anything up.

Maybe I am just really cardio unfit?

I had Afib and PSVT's pre-op but it was possibly just because my heart was enlarged and I was in heart failure.  I had some rhythm issues for 2 years post-op but now I am perfectly fine in that regard.  Still get occasional PVC's and PAC's but that is perfectly normal.

Will stay in touch and let you guys know how I am doing.

[Jerry_NJ]

Was your mitral valve leaky?  You say repaired, was a ring put in to limit the size of the opening the mitral valve has to close?  Do you have any rhythm problems?  Enlarged left atrium from the MV problem?  

As for having difficulty going 8 minutes on a treadmill that is very typical, I believe and is due in the most to: 1) lack of physical training/exercise, or 2) the operator was pushing you too hard.  I believe the only goal of a stress test difficulty is to raise the HR to a target level, say 80% of the maximum for your age.  

How is your lung capacity?  This is something my primary care doctor tests when I get an annual physical and also blood circulation in my lower body/legs as I too feel "weak legges" with very little stress.  But I have atrial fibrillation and that lowers the amount of blood my heart can pump even with a good EF, mine is about 65%.

I understand Australia has a government run health care system and thus understand why they check before taking people in, just like the old USA insurance problem of "pre-existing" conditions causing higher premium payments, or even rejection of coverage.

I have exchange infor with you in the past but it wasn't on heart issues, maybe on the ENT Community.

I usually spend my heart issue tine on the Heart Rhythm Community but occasionally "drop by" this Community.

Good luck, let us know how it all goes.

[Smiley2000]

My EF is 55% and no signs of pulmonary hypertension.

I am going to ask my Doctor to check for anemia.  That would explain why I feel weak, palpitations and SOB with minimal exertion.

Thanks!

[Paderla Anitha, DNB]

Hello and hope you are doing well.

Inadequate oxygenation can produce symptoms of breathlessness, as the body tries in an effort to compensate for the decreased oxygen supply. The breathlessness could be due to cardiac or lung disorders. If your exercise intolerance was due to a cardiac disorder, it would have been picked up by the stress test. What is your ejection fraction? Your symptoms could be due to lung disorders. Certain systemic disorders like anemia, can cause these symptoms. So please discuss this with your doctor, he may ask for blood tests and an X ray chest. Lung function tests could further help in evaluation.

Hope this helped and do keep us posted.