Medicine stress test

Why medicine stress test?

by Gotrhythm - 2018-04-17 13:12:41

You are already showing a degree of exercise intolerance. The doctor is conderned that with a regular stress test, where you walk on a treadmill, that you won't be able to walk long enough, or get your heart rate high enough for the test to be really useful.

With the medicine or chemical stress test, you will be able to lie on a gurney, being carefully monitored, and given a drug that will make your heart go very fast. Then they'll give you something to reverse the effects of the first drug. It only lasts a couple of minutes. It will take much longer to hook up all the EKG leads than to do the test.

You'll do fine.

More on chemical stress test

by donr - 2018-04-21 19:56:51

Here's the skinny

by donr - 2018-02-28 23:13:28 Edit

You asked for it - here it is, bells, whistles, warts & all!.  This really needs to be posted every now & then because there are new folks who haven't experienced it & hear horror tales about it.  It is NOT a walk in the park!  But, understood, it is bearable

Here, all in one spot, are at least three other comments on the test:

by donr - 2018-02-07

Below are three other comments from about 2 yrs ago.  First is mine.  This is the Lexiscan version of the test.  Lexiscan does NOT accelerate the heart - it dilates the coronary arteries to simulate the stressing of the heart.  Since it does NOT stress the heart by forcing it to face a heavy load that cannot be resolved quickly, it gains the same info by diulating its arteries in a way that CAN be reversed literally in seconds.

Word of warning - If there is NOT a "Crash Cart" close by, like w/i reach of the ooperator, SPRINT, don't run, to the nearest exit.  Don't come back.  The frirst time I took it, there was no cart in sight.  Second time, it was right at the foot of the chair bed I was lying on & the nurse-operator commented on how close it was - almost in her way.  This is not considered a dangerous test, but when things happen, apparently they happen fast.

DonR

"Lexiscan

by donr

2016-04-12 09:04:38

554 views

2 comments

Sometime in the last month someone asked about the Lexiscan chemical stress test. Well, I just had one on Mon, 11 Apr (2016) & made a mental note to give some details about it for those interested.

Apparently everyone reacts differently to the test & an individual's reaction may NOT be the same in successive tests a year or so apart.

I had my last one THREE yrs ago & it was a real disaster - the most unpleasant experience I've ever experienced in testing. The effects came on in a rush & were most unpleasant - very bad SOB & a very light headed feeling for several minutes, followed by a headache.

I did NOT look fwd to this one & became very stressed out about it over the three week run-up to the test.

Here's what happened: I was first in the queue Mon AM. There were 4 of us, all multiple time victims. One of us was in for their THIRD go-round. Her experience was different on each of the first two, so she had zero idea what to expect this time around.

They use an artificially made radioactive tracer element called Technecium w/ a half-life of 6 hours, so it is all expelled from your body in about 5 half-lives - about 30 hrs. The tracer is used in several different scans & is mixed w/ different meds for the different parts of the body being scanned. They told me the name of the med used for heart muscle, but I cannot recall it.

They give you a small dose of it IV to start, you sit for 30 min for it to be absorbed by heart muscle & then lie on a scanner bed while a large head rotates about the chest scanning for the radioactivity from the heart muscle. It creates a whole slug of images showing where the Technecium gets absorbed while the heart is unstressed.

Now comes the exciting part! they hook you up to an ECG & BP monitor & bring in two hypos - one w/ a second dose of Technecium & the other filled w/ the Lexiscan med. Here's how fast this goes: The nurse injects the Lexiscan into your IV, (the IV is in the back of the hand) followed by a small slug of saline to ensure all of the Lexiscan is in you. Then IMMEDIATELY the nuclear tech gives you the tracer.

It takes about 7 - 10 seconds for you to feel the effects & they are DRAMATIC! Suddenly you become very SOB & struggle to breathe. Then your BP drops like a stone as the Lexiscan med dilates your coronary arteries. You feel VERY light-headed & fuzzy. Also pretty darned weak. This lasts for perhaps a minute & you start coming back. W/i 5 min you are pretty near back to normal. You feel pretty washed out at this point & well may have a headache of variable severity, due to the arteries to the brain also being dilated. A decent cup of coffee clears that up in short order.

You sit for a while & then it's back to the scanner for a "Picture " of where the blood went while the heart was stressed & dilated. This time they hook you up to an ECG machine while taking the images.

The scans take 13min each. Total time for me was 3 hours from registration to walking out the door to leave.

For me this one was nowhere near as unpleasant as the first one - but I'm not volunteering for another one any time soon.

Donr

 

2 Comments

Lexiscan Victim !!

by donb - 2016-04-13 09:04:36

Hi Don !! Congratulations !! You survived, as I've been patiently looking forward reading someone posting on this procedure. You may remember my experience a few years ago & I did not have the "heart" to cover the procedure at the time.
I went online at the time & found very sound procedure to be complied while being given this test. In my case not one item complied with administering this drug.
Presently both my wife & I are due for this test & all the prior drugs are no longer used & our local GP even evades.
I haven't even had the courage to check online to see what the guidelines are now, also fatality figure is ??
Quite a day !! Wife Sharon (retired cardiac nurse) just came home as she took another nurse co-worker back to her Cardio
Doctor for after effects she's having from her Cardio Stress test 2 days ago.
I'll end this now on a happy note !! Lexiscan is now tops in Cardiac tests and more precautions are being used.
As I don't want to go into more detail but I was very fortunate to not fall into the 5% Fatality.
DonB

Me too!

by tammyjk1021 - 2016-05-26 05:05:51

I put this test off as long as possible until my husband threatened me with bodily injury lol. I was very comforted by the low fatality rates and in fact asked my test giver "how many people have issues". I was told "only those with very serious problems have issues and you have nothing to worry about." That helped.

I knew from my pacer checks that I needed to occupy my mind while under the stress of this test. Since it was mother's day, I took the card my daughter had made me to read. It helped soooo much. My biggest advice to anyone is to ask questions that bother you, keep your mind occupied and breathe breathe! Breathe through your mouth and out through your nose. That will also help."

chemical stress test

by softball35 - 2018-02-28 23:30:59

A treadmill test can not be done if you have a pacemaker.  It leaves an artifact according to my doctor.  Not sure what that means but I had the stress test last year.  A drug is injected that makes your heart react as if you had just excercised vigorously.  Nothing to it.  The doctor then took pictures of my heart during the process.  Nothing to it.  If there is something wrong you want to know about it now, not after it is too late.  I had a pacemaker inserted and I had ablation seven years ago.  I was shocked that I needed it.  But I am more active now than ever.  I wasted a lot of time worrying about both procedures.  Just do it.  Good luck.

More on chemical stress test

by donr - 2018-04-21 19:56:54

Here's the skinny

by donr - 2018-02-28 23:13:28 Edit

You asked for it - here it is, bells, whistles, warts & all!.  This really needs to be posted every now & then because there are new folks who haven't experienced it & hear horror tales about it.  It is NOT a walk in the park!  But, understood, it is bearable

Here, all in one spot, are at least three other comments on the test:

by donr - 2018-02-07

Below are three other comments from about 2 yrs ago.  First is mine.  This is the Lexiscan version of the test.  Lexiscan does NOT accelerate the heart - it dilates the coronary arteries to simulate the stressing of the heart.  Since it does NOT stress the heart by forcing it to face a heavy load that cannot be resolved quickly, it gains the same info by diulating its arteries in a way that CAN be reversed literally in seconds.

Word of warning - If there is NOT a "Crash Cart" close by, like w/i reach of the ooperator, SPRINT, don't run, to the nearest exit.  Don't come back.  The frirst time I took it, there was no cart in sight.  Second time, it was right at the foot of the chair bed I was lying on & the nurse-operator commented on how close it was - almost in her way.  This is not considered a dangerous test, but when things happen, apparently they happen fast.

DonR

"Lexiscan

by donr

2016-04-12 09:04:38

554 views

2 comments

Sometime in the last month someone asked about the Lexiscan chemical stress test. Well, I just had one on Mon, 11 Apr (2016) & made a mental note to give some details about it for those interested.

Apparently everyone reacts differently to the test & an individual's reaction may NOT be the same in successive tests a year or so apart.

I had my last one THREE yrs ago & it was a real disaster - the most unpleasant experience I've ever experienced in testing. The effects came on in a rush & were most unpleasant - very bad SOB & a very light headed feeling for several minutes, followed by a headache.

I did NOT look fwd to this one & became very stressed out about it over the three week run-up to the test.

Here's what happened: I was first in the queue Mon AM. There were 4 of us, all multiple time victims. One of us was in for their THIRD go-round. Her experience was different on each of the first two, so she had zero idea what to expect this time around.

They use an artificially made radioactive tracer element called Technecium w/ a half-life of 6 hours, so it is all expelled from your body in about 5 half-lives - about 30 hrs. The tracer is used in several different scans & is mixed w/ different meds for the different parts of the body being scanned. They told me the name of the med used for heart muscle, but I cannot recall it.

They give you a small dose of it IV to start, you sit for 30 min for it to be absorbed by heart muscle & then lie on a scanner bed while a large head rotates about the chest scanning for the radioactivity from the heart muscle. It creates a whole slug of images showing where the Technecium gets absorbed while the heart is unstressed.

Now comes the exciting part! they hook you up to an ECG & BP monitor & bring in two hypos - one w/ a second dose of Technecium & the other filled w/ the Lexiscan med. Here's how fast this goes: The nurse injects the Lexiscan into your IV, (the IV is in the back of the hand) followed by a small slug of saline to ensure all of the Lexiscan is in you. Then IMMEDIATELY the nuclear tech gives you the tracer.

It takes about 7 - 10 seconds for you to feel the effects & they are DRAMATIC! Suddenly you become very SOB & struggle to breathe. Then your BP drops like a stone as the Lexiscan med dilates your coronary arteries. You feel VERY light-headed & fuzzy. Also pretty darned weak. This lasts for perhaps a minute & you start coming back. W/i 5 min you are pretty near back to normal. You feel pretty washed out at this point & well may have a headache of variable severity, due to the arteries to the brain also being dilated. A decent cup of coffee clears that up in short order.

You sit for a while & then it's back to the scanner for a "Picture " of where the blood went while the heart was stressed & dilated. This time they hook you up to an ECG machine while taking the images.

The scans take 13min each. Total time for me was 3 hours from registration to walking out the door to leave.

For me this one was nowhere near as unpleasant as the first one - but I'm not volunteering for another one any time soon.

Donr

 

2 Comments

Lexiscan Victim !!

by donb - 2016-04-13 09:04:36

Hi Don !! Congratulations !! You survived, as I've been patiently looking forward reading someone posting on this procedure. You may remember my experience a few years ago & I did not have the "heart" to cover the procedure at the time.
I went online at the time & found very sound procedure to be complied while being given this test. In my case not one item complied with administering this drug.
Presently both my wife & I are due for this test & all the prior drugs are no longer used & our local GP even evades.
I haven't even had the courage to check online to see what the guidelines are now, also fatality figure is ??
Quite a day !! Wife Sharon (retired cardiac nurse) just came home as she took another nurse co-worker back to her Cardio
Doctor for after effects she's having from her Cardio Stress test 2 days ago.
I'll end this now on a happy note !! Lexiscan is now tops in Cardiac tests and more precautions are being used.
As I don't want to go into more detail but I was very fortunate to not fall into the 5% Fatality.
DonB

Me too!

by tammyjk1021 - 2016-05-26 05:05:51

I put this test off as long as possible until my husband threatened me with bodily injury lol. I was very comforted by the low fatality rates and in fact asked my test giver "how many people have issues". I was told "only those with very serious problems have issues and you have nothing to worry about." That helped.

I knew from my pacer checks that I needed to occupy my mind while under the stress of this test. Since it was mother's day, I took the card my daughter had made me to read. It helped soooo much. My biggest advice to anyone is to ask questions that bother you, keep your mind occupied and breathe breathe! Breathe through your mouth and out through your nose. That will also help."

chemical stress test

by softball35 - 2018-02-28 23:30:59

A treadmill test can not be done if you have a pacemaker.  It leaves an artifact according to my doctor.  Not sure what that means but I had the stress test last year.  A drug is injected that makes your heart react as if you had just excercised vigorously.  Nothing to it.  The doctor then took pictures of my heart during the process.  Nothing to it.  If there is something wrong you want to know about it now, not after it is too late.  I had a pacemaker inserted and I had ablation seven years ago.  I was shocked that I needed it.  But I am more active now than ever.  I wasted a lot of time worrying about both procedures.  Just do it.  Good luck.

I just went through this myself

by KieferSkunk - 2018-04-27 04:01:43

Hi Gotrhythm.  It sounds like you're going through much the same issue that I just did recently.  I have been pacer-dependent since 2002 (3rd-degree AV Block, congenital) and was starting to have trouble with low exercise tolerance, dizzy spells, difficulty concentrating, persistent cough, etc.  I just moved last September and saw my new cardiologist in November, and before even knowing about these symptoms, he ordered an echocardiogram, saying that people like me who have been on pacemakers for extended periods of time are statistically more likely to develop congestive heart failure.

Sure enough, the echo showed a 35% ejection fraction, which he deemed "critically low" - as in, I could just up and die at any moment.  He then had me do a chemical stress test, and he explained that I'd be doing that instead of a treadmill because the treadmill test would put too much strain on my body.  Given I could barely walk my dog and wasn't even able to mow the lawn anymore, I agreed with his assessment on that.

The office did a ton to make sure I was prepared for the test, told me what to expect (including pain), etc.  But when they injected the drug and my heart started racing, I swear I saw my life flash before my eyes.  I experienced real angina for about ten seconds - about the only way I can describe it was that it was a deep, intense pain that arched up into my shoulder and partway down my left arm, and it came with it about the most primal sensation I've ever had of "I am about to die".  It was all I could do to keep from panicking, and thankfully it was over in a minute or so.  They had me drink a bunch of coffee just after the test to flush the medicine away, and I felt better in minutes.

I described those symptoms to the techs and to my doctor, and they said that the symptoms definitely matched the echo and the imagery they got in that test - my heart was unable to pump blood and oxygen fast enough to keep up with even its own demand.

If it turns out you have the same problem as me, it's a condition known as "pacemaker-induced cardiomyopathy", and is apparently an increasingly-common problem with people who have been on pacemakers for a while.  The problem is electrical, and similar to AV block, except that it is a loss of coordination between the left and right halves of the heart.  As it was explained to me, this condition effectively makes the heart become "lazy".  In my case, it impacted the amount of blood being pumped per beat, rather than the rate at which it was being pumped.  And it meant that my current pacemaker program was no longer effective - while it was treating the AV Block, it was causing an even more serious problem.

If that's what your case is, your doctor is right to tell you to do the chemical test.  I hope it won't be as scary for you as it was for me, and I really hate to sour your expectations with this.  But my sincere hope is that if you do experience those same symptoms, you'll remember my post and those of others here and that we survived and ultimately got better.

I had my dual-chamber pacer upgraded to a biventricular (3-lead) pacer on April 3rd this year, and I have to tell you, I felt like Superman for the first few days post-op.  It really was a night-and-day difference for me.

Best of luck to you.

What next

by tommiker70 - 2018-05-02 18:40:54

Well I had my Nuclear Medicine stress test last Friday. Doctor called with the results. Told me I had no blockage. There was a wakening of my heart. My Ejection Fraction was 36%, two years ago it was normal about 50%. He wants to do an echocardiogram to get more information next week. Said I could continue with my hiking and bike riding, let my body tell when to stop or rest. Might have Cardiomyopathy. I just do not understand, two years ago I had this pace maker put in because my heart was beating to slow. They told me the rest of my heart was fine, strong Doing ok for almost two years. Started to get out of breath on hills like never before. Now this,  were did this come from. Two years down to 36%. How long do you all think I have left? How far am I from a weal chair. Sorry feeling very sorry for my self right now. Any thoughts would be appreciated.