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Stress Test Blood Pressure

I recently had a cardiopulmonary stress test done, and I'm having a hard time interpreting the chart/summary.  Is it ever okay to have a drop in blood pressure with an increase in speed/grade?
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976897 tn?1379167602
This is quite a large topic because there are many things which can affect blood pressure. Usually when you exercise, you see a drop in pressure and then it quickly recovers. This is because your arteries will open up, to allow a much greater flow of blood to the muscles. Your heart has to then compensate to increase the pressure, by working harder. There is nearly always a delay, but the delay is greater in some people than others. For example, the more unfit a person is, the longer the delay. Even a bit of dehydration will affect that delay. If you have eaten within a couple of hours before a stress test, this can greatly affect it too. This is because a large portion of your blood volume is busy feeding the digestive system, leaving less for your muscles. This is why we puff and pant if we try to jog after a meal. If the specialist is concerned about your blood pressure, then an investigation will take place to try and discover where the problem lies.
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976897 tn?1379167602
I just want to ask, do you know by how much the pressure dropped? was the top number or bottom number, or both affected? were they both 10 or greater in reduction?
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Avatar universal
Thank you so much for all this information.  I just don't feel very comfortable with the cardiologist, and they're about an hour and a half from where I live anyway.  I have an appointment with my Primary Care Manager next week, and I'm just trying to figure out if this is worth bringing up. I was being evaluated by a cardiologist because I've been having lightheadedness and a kind of tunnel vision when working out like I'm going to black out, and it was taking about an hour to really recover/feel better after running or playing volleyball (which doesn't seem that strenuous to warrant that kind of reaction).  I was also having random shortness of break like... I'm looking for my shoes and need to sit down because it's hard to breathe.  I'm a 27y/o female and in very good shape.  I'm in the military and we have physical training three times a week, but I typicaly work out five days a week.  A little prior to me going to the doctor, I was on a crossfit program, but I was getting back to my normal lifting weights and running/elliptical routine.  We normally eat pretty healthy, and I would estimate that I drink about 80 ounces of water a day.  This test was done in the late afternoon so I hadn't eaten for a while... actually when it finished we went to get dinner before the trek home.  (Hope this helps)  My blood pressures for the test are as follows:

Supine: 88/75 (which is pretty low for me - I'm normally about 112/72-ish)
Standing: No measurement
Stage 1: 126/75 Stage 2: 121/72 (slight drop in both)
Stage 3: 133/67 (slight drop in bottom)
Stage 4: 121/72 (larger drop top, slight increase bottom)
Stage 5: No Measurement
Recovery: 108/68

I think I actually had a little bit of the fuzzy tunnel vision during Stage 4, but it wasn't as bad as normal.

If you need more info like the time in stage, VE, ST Level, etc, let me know.  Like I said, I have the whole Tabular Summary with the crazy graphs and everything.

Thank you!!
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976897 tn?1379167602
There was a substantial drop in systolic pressure at stage 4, more than 10. Do you know your heart rate in each stage?
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Avatar universal
Supine: 104
Standing: 101
Stage 1: 115
Stage 2: 131
Stage 3: 146
Stage 4: 184
Stage 5: 193
Recovery: 134
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976897 tn?1379167602
Stage 4 is definitely showing a problem. Virtually 40 beats a minute increase in heart rate, yet a substantial drop in systolic pressure. It's like putting an extra heart into your body, and it making no difference in helping the pressure.I am not a Doctor, but it does look as though there is an issue there. From most blogs, it would seem if systolic drops by 10 or more, then this is a strong pointer for heart disease. However, given your age, and healthy lifestyle, I can't see it. Also, to reach 193bpm, you would have chest pains or be panting like a dog on a hot day. I could make a guess as to what I think is wrong, but I won't be surprised if they want to run more tests. I think they should at least run an echo scan, to make sure the anatomy is fine. If there are no changes in the ST segment and T wave on the ECG trace, then this is a big bonus. Please let me know what they say, it's very interesting, but I also know it's concerning for you.
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Avatar universal
I'm not sure what "changes in the ST segment and T wave" means exactly.  They report says that I had nonspecific T wave abnormality during the stress test, but they didn't seem too concerned about that.  The ST Level V5's were:
Supine: -0.15
Standing: -0.10
Stage 1: -0.50
Stage 2: -0.60
Stage 3: -0.25
Stage 4: 0.10
Stage 5: 0.30
Recovery: -0.55
Not sure if any of those are good or bad.  Some of this information is really hard to research when you don't know what you're looking for.  Lol!  Like the VE (because it all seems to be related to VO2... but I don't see that on the report) and trying to figure out how to read the little graph things because some of the numbers look bigger.  I don't even know what to look for!

We also did an echo and they found mild regurgitation from my pulmonic valve, but indeterminate pulmonary systolic pressure estimates, TR  Velocity, and RVSP.  Pretty much all of the numbers look okay, but I was maybe concerned with the Mitral Valve measurements E - 0.8 m/s, A - 0.5 m/s, E' - 0.12 m/s.  *Sigh*  I'll keep you in the loop.  This road has been long and frustrating so far...
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Avatar universal
My doctor just said that they were normal physiological changes in response to exercise.
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976897 tn?1379167602
That's great news. I've just been reading a report written by cardiologists at the mayo clinic which states... There has been a gradual reduction of heart attacks in women thanks to a study that was done and observed thousands of patients. It seems that recovery after exercise, e.g. time involved, is just as important as the way the heart behaves during exertion. It also states that a significant drop in systolic pressure (10 or more) during exercise can be a strong clue for some hidden problem.
I'm sure your Doctor is aware of this and has made the right conclusion from your test results. Thanks for letting me know :)
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Avatar universal
To be honest, I'm still not very comfortable with the answer that I got.  I understand that by reading the dictation/interpretation - it sounds like everything was good...and that is what my PCM is going off of.  I also understand that my PCM is not a cardiologist.  I'm going off of my internet research based on the test itself.  Pretty much all of the stuff that I've read says that drop is concerning, or even grounds for stopping the test (which didn't happen).  I appreciate your help in this!  If I get an update, I'll let you know!
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