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First Annual Heart Health Nag
#4889 10/12/09 03:14 AM
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ryck Offline OP
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Some of you may recall about a year ago I wrote about my surprise quintuple bypass and how I would never have known I was in danger except my Doctor sent me for a treadmill stress test.

In this test you walk on a treadmill while wearing an electrocardiogram and blood pressure monitor so that your heart performance can be evaluated under stress as opposed to simply sitting in the doctor’s office.

I didn't have any of the conditions that most of us think of as the usual indicators of heart problems so I had never thought “heart attack” - cholesterol was reasonable, no angina-like pains, no squeezing chest pains, no pain in my arms, no increasing episodes of chest pain, et cetera.

The Cardiologist, who was responsible for the test, said that about 30% of the people who die of heart attacks don't have the typical pointers so they don't consider the possibility of a heart attack. They just drop dead unexpectedly.

So…here comes the first annual nag…I urge you to talk to your Doctor about getting a treadmill stress test as a preventive health measure even if you think you're fine.

ryck

Last edited by ryck; 10/12/09 03:07 PM. Reason: Clarification

ryck

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Re: First Annual Heart Health Nag
ryck #4896 10/12/09 10:44 AM
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I've heard that treadmill stress tests are now discouraged, because they can cause heart attacks in and of themselves.

Do the new drug-induced-stress tests yield less accurate results in some/all circumstances?

(My two friends who've taken the newer tests are both extremely overweight, and that factor may have been the determining one.)


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Re: First Annual Heart Health Nag
artie505 #4900 10/12/09 12:55 PM
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I suppose the ability to "run" the test depends on the health of the patient. But, the test is supposed to reveal the health of the patient. It's a vicious circle. You're on a treadmill before you get on the treadmill.

I completed the thing to the end. My doctor was impressed. He said most people have to stop before the jogging stage. My weight is also an issue. My wife says I'm too thin! The doc says "never too rich, never too thin" unless you're anorexic.

Re: First Annual Heart Health Nag
artie505 #4906 10/12/09 03:02 PM
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I don't know where you heard that treadmill stress tests are now discouraged. They're still the gold standard when it comes to assessing cardiovascular fitness.
Clearly, patients with overt or suspected cardiac pathology would be dealt with gingerly.
The chemical stress tests which also involve radioisotope administration and scintigraphy are ancillary and can pick up pathology which is not able to be diagnosed via the treadmill.
Once pathology is discovered, other test procedures to determine its extent are invoked and appropriate remedial steps taken. For example, echocardiograms and invasive fluoroscopy (angiograms) figure in here.
Even the marathon runner, Jim Fixx, would not likely have been caught by any of the testing. He dropped dead doing what he loved, ie running.

Re: First Annual Heart Health Nag
artie505 #4907 10/12/09 03:04 PM
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ryck Offline OP
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Re: [i]I've heard that treadmill stress tests are now discouraged, because they can cause heart attacks in and of themselves.[/i]

I've not heard that although, during my test, a Registered Nurse was present. I was quizzed from the moment the test started and I was pressed for answers. For example, a very low-grade pain ( and I mean hardly noticeable) was cause for concern. The test ended up being only about three minutes.

The day after, an angiogram was done to confirm suspicions.

A year later, I feel much better than I did pre-operation and that may be a commentary on how insidious heart disease is. You don't think that you should feel better than you do. You just think that things are not quite as good as they used to be because you've put on a few more miles.

ryck

Last edited by ryck; 10/12/09 03:18 PM.

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Re: First Annual Heart Health Nag
artie505 #4908 10/12/09 03:35 PM
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Originally Posted By: ryck
So…here comes the first annual nag…I urge you to talk to your Doctor about getting a treadmill stress test as a preventive health measure even if you think you're fine.
Thanks for the reminder ryck. I had my stress test five months ago around my birthday. It is a good idea for any of us beyond "a certain age" or who are not in good physical training or condition.
Originally Posted By: artie505
Do the new drug-induced-stress tests yield less accurate results in some/all circumstances?
Stressing the heart carries the same risks, and the results are generally comparable, whether the stress is induced by physical exertion or medication. Drug induced stress testing is usually reserved for those persons who are unable to exercise because of medical conditions such as COPD and physical injury or incapacitation.

There are variants based on specialized imaging that your doctor may or may not choose to have performed such as nuclear imaging to check the blood flow through the heart itself, before and after stress. But in the end, and in spite of the risk, there is no substitute for a stress test to determine heart health before an attack occurs.

After an attack, blood enzymes can confirm an attack has taken place, but that is of course after the fact and far too late to take any preventative measures. There have been claims that full body radiological scans may be able to detect pre-cursor conditions for a heart attack but here the operative word is may. Full-body scans are notorious for false positives and in the case of a potential heart problem the condition would still have to be confirmed by a stress test. So instead of dodging a bullet, you are spending a lot more money for an inconclusive procedure. (My son is a Radiologist and chooses not do full body scans for that reason as well as his belief that much exposure to radiation is unwise unless there is an overriding reason.)


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Re: First Annual Heart Health Nag
joemikeb #4910 10/12/09 06:33 PM
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Re: First Annual Heart Health Nag
joemikeb #4911 10/12/09 08:55 PM
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Ryck has raised very important issues and I am very happy that his condition was caught on time. Concerning the treadmill test, there are several variants now as you mentioned. One is a standard treadmill test when a person has to walk on a treadmill. AFAIK, it does not involve jogging, just a fast walk in the end. Mine were for full 8 minutes. For people who may be less fit, there is a bike test. A person lies down on a special couch equipped with a standing bike and exercises while in horizontal position. This is an easier test. Finally, for the elderly, there is a chemical stress test as well as you said. My last one was on a bike and it was with a reputed cardiologist in his well-equipped office.
I agree with the other posters that some kind of stress test is being widely used and, I guess, will be in the foreseeable future.
P.S. If the allegations in the article check out, I would put the nurse out for a very long time. This is real crime.

Last edited by macnerd10; 10/12/09 08:58 PM.

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Re: First Annual Heart Health Nag
macnerd10 #4912 10/12/09 10:31 PM
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ryck Offline OP
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It was a nurse who provided the only humour, in retrospect (but not at the time), during my stay in the hospital.

It was the evening before the operation. Both of my daughters, who had come in from other cities, and my wife were with me. My daughters were all weepy and teary so my work was cut out - get them calmed down and feeling less worried.

I proceeded to describe how the hospital had been doing bi-passes for twenty years and did about 850 per year. The Cardiac Surgeon was the best and the Cardiologist had even said that, if he was having this operation, that's the surgeon he would want.

I no sooner had them calmed down and even laughing a bit when a nurse came in to take blood pressure. She blurted out "Isn't that nice, you have your whole family with you. Don't forget to talk about what happens if you don't make it."

Waaaaaaaa!!! Oh jeez, back to square one with the calming down.

ryck

Last edited by ryck; 10/13/09 10:06 AM. Reason: Additional Info

ryck

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Re: First Annual Heart Health Nag
ryck #4927 10/13/09 05:55 AM
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This could have been square one but now it should be cloud nine!
Hope you are enjoying your new life. They all say that the main benefit of a bypass is a dramatic improvement of the quality of life.

Last edited by macnerd10; 10/13/09 05:55 AM.

Alex
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Re: First Annual Heart Health Nag
macnerd10 #4929 10/13/09 10:05 AM
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ryck Offline OP
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Thanks for your kind thought. You're right, life is much better...and I hope that my "nag" will move unsuspecting others to get the kind of help that can extend their lives.

ryck


ryck

"What Were Once Vices Are Now Habits" The Doobie Brothers

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