Pulled off the treadmill stress test after only 3 stages, good or bad?

[scoracek]

I just got done getting my stress test and Echo done, before the stress test my BP was really high like 136/something, I had a Drs appt. an hour earlier where they checked my BP and it was 115/93, I don't have high blood pressure, usually fluctuates between 120-100/something. During the test I saw it go up to 190/something. The tech stopped me shortly after the third stage started (about 9 minutes in). After sitting there and having them check my BP multiple times, I was told to go have a seat in the waiting area, before I left the room I looked at the results quickly and it said "This treadmill test indicates patient is at very high risk." Is that bad? Shortly after sitting there they told me I could go have my echo and when I was walking to another room I got dizzy and almost fell into the wall and then my chest started hurting (went away after about 20 mins during the echo). The echo cardiologist called the lady who did the stress test and told her and she said that she would run another EKG after the echo. When she did that she said that they were the same as the others (have no idea what that means because I never saw the results, but I did have an abnormal EKG last week) but then asked me when my next appt. with my cardiologist was, I told her mid August and she said we can definitely get you in sooner. She said that the tests would be read and that I would get faxed the results by tomorrow or Friday. Now I can't stop coughing. Should I be worried? Why would she stop me before the test was complete, especially not even ten minutes in? Any help would be greatly appreciated!

[scoracek]

What could the drop mean?

[Ger57]

Well, I do not see much alarming in the results you gave.

The quality of the images they got from the doppler test was not very good, which makes it difficult to draw reliable conclusions from them. That explains the terms "not well seen" and "likely". The image quality differs from person to person and depends mainly on the amount of tissue between the heart and the probe.

The trace regurgitation (insufficiency) of your valves is no problem.

During the test, your diastolic bp went from 78 to 50. That is more drop than usual. It could be that is the reason they stopped the test.

[scoracek]

What could the drop mean and is it a bad sign?

[Ger57]

I would not be honest if I said that I expect that everything is normal.
Is is however at that moment just guessing about the extent of the abnormality and the consequences of it.

You will just have to wait till thursday.
Will you let me know the outcome of the consult?

Take care,
Ger

[scoracek]

Yeah definitely, I finally got them to send the results.

1). Bruce protocol stress test: Exercise duration: 9:04, Heart Rate Achieved: 178 (88% PMHR), Target Heart Rate: 171 (85% PMHR), METS: 12, BP Response: Normal blood pressure response to exercise. Baseline BP: 138/78, Peak BP: 182/50,
Baseline EKG: Normal sinus rhythm, RAD, Nonspecific ST-T wave abnormalities.
Exercise EKG: No ischemic ECG changes. Nondiagnostic due to baseline changes but no significant findings during exercise, no significant arrhythmias.
Conclusion: Exercise EKG unremarkable for significant arrhythmias.
I knew that the exercise wouldn't cause any chest pain because the chest pain occurs at rest, like when I'm sitting or lying in bed, occasionally it'll wake me up.

2). Really wish I could just take a picture of the results. Don't really want to write a book on this because there's so much so I'll summarize it a bit.

BP: 100/68

Impressions: Left ventricular ejection fraction estimated at 75%, No significant valvular disease, No color Doppler evidence of interatrial shunting.

I fit into the measurement guidelines for most of it but my Septum, Posterior Wall and Left ventricular outflow tract diameter all don't have measurements.

The rest I don't feel like listing everything cause it's a lot and I don't expect or really want you or anyone to have to read all of it, so I'll just list the stuff that I think is odd.

Interpretation by M-Mode and Two-Dimensional
Aortic valve: not well seen but is likely trileaflet. There is no aortic stenosis or insufficiency by Doppler eval.
Pulmonic valve: Not well seen.
Tricuspid Valve: Normal, Size: Normal, Wall thickness: Endocardium is not well seen and wall thickness cannot be evaluated correctly.
Inferior Vena Cava: Nothing written, Function: Nothing written again, Wall motion: Grossly normal with hyperdynamic function estimated at 75%.

Interpretation of spectral and color flow Doppler: virtually no measurements are listed here next to the abundance of things, however it does say Mitral Regurtitation: Trace. And other says: "Diastology is grossly normal for age."

Thats everything, sorry if it looks as long as a Harry Potter book. I have some questions: Why would Right Axis Deviation suddenly show up on my EKG when all the other ones I've had its never been there? Nonspecific ST-T wave abnormalities on there again, what does this mean? And like what could cause my HR to rise and fall like this? I check it all the time at rest and I'll either get above 60 (normal) or below 60 (abnormal) sometimes as low as 42bpm, and both times I've gotten an EKG with the exception of the stress test, I've had a below normal HR so it's not like it's my nerves or anything.

Regarding the echo, is it bad if there aren't measurements next to something or if something's not well seen? What does "grossly normal" mean? Because they frequently wrote that while also using just plain "normal" in different areas. And FINALLY, if everything looks normal (which I have absolutely no idea how to read these things), why would my cardiologist want to see me so urgently, instead of just saying "everything looks great!" Could this mean she wants to run additional tests or that she saw something wrong? Because like I said, the chest pain doesn't come on with exertion, it's just at rest, pretty sure that ain't good. Again I know I'm asking a lot from you Ger and I really appreciate all the help and support you've provided! But I'm just trying to see if you have any opinions as to what I could expect to be said to me on Thursday?

Thanks so much!

[scoracek]

Oops missed something, it also says: Tricuspid Regurgitation: Trace. And Pulmonary Insufficiency: Trace. I guess the latter could indicate why the Pulmonic valve was not well seen.

[Ger57]

These are a few exiting days coming up for you. I went through the same process so I can understand what you are going through.

Try to relax (probably easier said than done) and avoid strong physical activity till your appointment.

[scoracek]

Yeah, it's going to be really tough with the long weekend ahead without work or school not to obsess over it. My chest pain comes on mainly when I'm at rest or lying down so I wasn't surprised to have any during the test. Like I think she pulled me off because I think I reached my Max HR, in only nine minutes though, could that mean bad? Like this cardiologist is really nice and is the only Dr I've had that actually seems to care and actually makes eye contact with me when I'm talking to her instead of turning around and typing away at a computer barely listening.

[scoracek]

Oops clicked submit by accident, I was going to say that I find it very strange and nerve wracking that I requested an EKG the day after I first saw her last week and I got it immediately and after that appt. she wanted to see me in August and now all of the sudden, after these tests she wants to see me in a week and I can't even get the results to see for myself before then (any experience with a situation like that?). Like I know if it was immediately life threatening she would have either saw me today or I'd be in the hospital already but it's hard not to see anything not being wrong considering the fact that she had her staff call me the day after the tests were done and the testing center that I went to says that they aren't in the system yet, meaning that she has them and obviously knows something's up.

[scoracek]

Think my last comment didn't get posted, so I'll just make it short, when I first saw my cardiologist she gave me an EKG, I asked the front desk staff for the results the next day and they sent it right to me. It's hard not to think that something could be wrong here because they won't even let me have these results. The tests were done at an outside facility that my cardiologist also works at and they're saying that the results aren't available yet, even though her main hospital practice called me today saying she wanted to see me Thursday (which means someone knows the results), which is concerning because she wanted a follow up in August, even though she knew I was getting the tests this week. Which leads me to believe that she is holding the results because she knows something is wrong.

[Ger57]

A blood pressure of 136, and up to 190 during the test is not abnormal.

During the test they monitor your heart with the EKG apparatus.
The fact that they pulled you of the test probably means that there was an abnormality seen in the EKG. The remark "patient is at very high risk" also indicates there is something wrong.

I strongly suggest that you, as suggested by the examiner, see your cardiologist sooner than august.

[scoracek]

Thank you so much for explaining that! I actually just got a call from the cardiologist' office and my Dr wants to see me next Thursday, they wouldn't even fax me the results or just tell them to me because they apparently "aren't in the system." Now I'm scared and nervous and this is the only thing I'll be able to think about till Thursday. Surely the Dr wouldn't want to waste her or my time by scheduling an appointment just to say that everything came back normal?