Another Calcium score thread, if you can stand it

[ratface]

Anyone care to elaborate on their stress test, perhaps your age, your METS score, was the,
"Bruce" protocol followed for your tests, if so how far did you get?

 

[Koolau]

Updating on second Cardiologist consultation/opinion. I was somewhat expecting the same opinion as my first cardiologist consultation but what a different approach this doctor has. First an in office EKG which I failed. To my astonishment if your heart beats at less than 60 BPM or higher than 100, you will automatically fail an EKG, mine was 59 BPM, nonetheless I am officially classified as failing an EKG, he shrugged his shoulders giving me the impression it was non significant. Dr. Google states it can actually be a sign of a healthy heart since it can accomplish it's work with less effort. Then he scheduled a nuclear stress test which I have next week, an ultra sound aorta screening (which Dr. Google says is recommended for men over 65), an ultra sound of the Carotid arteries, a litany of bloodwork and a return visit in two months to discuss findings. I am ambivalent about it, relieved someone is looking further and concerned about what they may find, at least it's proactive and I will gain some insight into my heart health instead of feeling like a walking time bomb all the time. I walked out trying to understand how two highly respected cardiologists can have two widely different opinions. I have a busy two months of scheduled diagnostic testing, any insight/experience with any of the imaging tests would be of interest to me?

Happens all the time. DW's and my Cardiologist retired and our new one changed up everything we were doing and seemed to emphasize certain things while old one emphasized other things. Changed all of our meds around. I think it's more art than science in some situations. YMMV

 

[aja8888]

Anyone care to elaborate on their stress test, perhaps your age, your METS score, was the,
"Bruce" protocol followed for your tests, if so how far did you get?

The stress tests I took a couple of weeks ago, I had a MET score of 4.6 (target for my age is 4.3). I'll be 81 in a month. I completed both the treadmill 5 minutes run and the nuclear part with no trouble.

No issues were found with my heart and arteries other than a Level 2 heart block that showed up on the EKG which we knew I had. Recently fixed with a pacemaker install.

 

[joesxm3]

Anyone care to elaborate on their stress test, perhaps your age, your METS score, was the,
"Bruce" protocol followed for your tests, if so how far did you get?

I had a stress echo test.
Patient exercised into stage 3 of the Bruce protocol.
8.5 METS. 105% of max predicted heart rate 153 bpm.
6 min. 30 sec. Age 67.

First cardiologist said there were some abnormalities indicating a blockage. He wanted to do angiography.

I was resigned to going to the cath lab but switched to a local cardiologist recommended by my friend who was a Cath lab nurse. The second guy said my test was not that bad and agreed with me that the only reason to do invasive angiography would be to have the option of stenting. He said my likely blockage is in a smaller artery that they do not put stents in. He prescribed 10 mg rosuvastatin and told me to continue my aggressive lifestyle modification. So far so good. Check back in November.

He said if I have any symptoms he would do some external PET scan imaging.

 

[audreyh1]

The stress tests I took a couple of weeks ago, I had a MET score of 4.6 (target for my age is 4.3). I'll be 81 in a month. I completed both the treadmill 5 minutes run and the nuclear part with no trouble.

No issues were found with my heart and arteries other than a Level 2 heart block that showed up on the EKG which we knew I had. Recently fixed with a pacemaker install.

How did it go aja888?

 

[aja8888]

How did it go aja888?

It was installed yesterday morning at 7 AM and I was home before noon, I have the usual restrictions for two weeks about not lifting my left arm above my head or reaching behind my back. Plus, no driving for two weeks (haha). The pain is tolerable and I am taking Tylenol for it which helps. Last night, my IWatch recorded a sleeping heart rate of 60 BPM where the pacemaker is set at. I feel OK and never really felt bad through any of this stuff (stent issue, heart block).

The Medtronics Pacemaker monitoring software is downloaded onto my new iPhone so there is no need for a separate device at home.

So I am good as new now (for a while..LOL).

 

[Koolau]

It was installed yesterday morning at 7 AM and I was home before noon, I have the usual restrictions for two weeks about not lifting my left arm above my head or reaching behind my back. Plus, no driving for two weeks (haha). The pain is tolerable and I am taking Tylenol for it which helps. Last night, my IWatch recorded a sleeping heart rate of 60 BPM where the pacemaker is set at. I feel OK and never really felt bad through any of this stuff (stent issue, heart block).

The Medtronics Pacemaker monitoring software is downloaded onto my new iPhone so there is no need for a separate device at home.

So I am good as new now (for a while..LOL).

Good to hear. Thanks for sharing. We hope you wear out several batteries!

 

[ratface]

AJA888, good to hear, I have a friend who has had a pacemaker for many years and is an avid hunter, travels all over the world, seems to lead a very normal and comfortable life, all the best to you!

 

[RE2Boys]

Anyone care to elaborate on their stress test, perhaps your age, your METS score, was the,
"Bruce" protocol followed for your tests, if so how far did you get?

Background, had chest pain one Sunday almost exactly 5 years ago, to the ER, cath lab, then quad bypass surgery 3 days later (and a stroke 3 days after the surgery.

Since I told my cardiologist about an episode I had back in February during an organized trail run (dull chest pain during and in the hours after the run), he decided a nuclear stress test would be a good idea to check on the viability of the bypasses. I wrote if off at the time as mild angina due to the 20 degree weather (and 2 inches of snow)

Just had the stress test three days ago. Waiting for the doc to brief me on the findings. Some reports are available online:

Age 74
METS score 12.0
Bruce Protocol, stage 9 (they asked what my max HR during my trails runs (in 140s) they shut down the test at 141 and 11 minutes (my fitbit says I hit 147 in yesterday run)

MY EKGs are always labeled abnormal, possibly due to resting heart rate was 48 which is on the low side of what I consider normal (high 40s to mid 50s)

The run in February was the first organized run I've participated in in over 10 years. Not doing that again. Have gone back to running alone, at my own pace, stopping to rest or catch breath as needed and not having the psychological pressure of keeping up. Typically 3 miles.

The stroke was a much bigger issue than the heart, took over a year to regain cognitive skills (reading, writing, and arithmetic logic).

 

[ratface]

RE2boys, that's an impressive stress test, thanks for sharing your story

 

[aja8888]

Good to hear. Thanks for sharing. We hope you wear out several batteries!

Yes, hope at least two batteries!

 

[aja8888]

AJA888, good to hear, I have a friend who has had a pacemaker for many years and is an avid hunter, travels all over the world, seems to lead a very normal and comfortable life, all the best to you!

Thanks! I plan on staying as active as I have been.

 

[ratface]

If I use the standard formula for calculating maximum heart rate for my age at 65 it would look like this, 220 minus 65=155bpm. Bruce protocol says they stop the test at 85 percent of max which is only 131.75bpm, I imagine I will get there fairly quick at either stage 3 or 4 giving me between 7-10 METS, doesn't seem like enough time to gain valuable information, has anyone been allowed to go further or is it an automatic stop per protocol, my cardiologist asked me to ask them to let me go 1 min further for what reason I don't know. Does anyone give an indication of results or do you have to do the dreaded wait for results to be posted in your
" MY CHAR"T portal?

 

[joesxm3]

As I said in my previous post. I went to 105% of my max heart rate.

I had some EKG abnormalities that the doctor said were starting at heart rate 120 and not only at 155. The ultrasound also showed some heart muscle movement issues indicating ischemia.

 

[ratface]

So that begs the question, can I ask to go further or is protocol strictly followed unless stipulated by previous doctor clearance?

 

[joesxm3]

I guess it is up to your doctor.

In my case the nurse running the test seemed to decide on the fly depending on how tired she thought I was getting or maybe some things she was monitoring.

She seemed to have discretion power. I was surprised they did not stop at 85%.

 

[Koolau]

If I use the standard formula for calculating maximum heart rate for my age at 65 it would look like this, 220 minus 65=155bpm. Bruce protocol says they stop the test at 85 percent of max which is only 131.75bpm, I imagine I will get there fairly quick at either stage 3 or 4 giving me between 7-10 METS, doesn't seem like enough time to gain valuable information, has anyone been allowed to go further or is it an automatic stop per protocol, my cardiologist asked me to ask them to let me go 1 min further for what reason I don't know. Does anyone give an indication of results or do you have to do the dreaded wait for results to be posted in your
" MY CHAR"T portal?

My metoprolol would never allow my heart to beat that fast. Last time I was scheduled for a stress test, I stopped metroprolol for 2 or 3 days before hand.


DW couldn't actually "do" the stress test (tread mill) so they used dobutamine to make her heart go faster.

My point is that meds can be critical when planning a stress test. Make certain your doc (and the stress test unit) knows what you're on.

 

[ratface]

there are two pages of restrictions and pretty sure Metroprolol is on the list, going to miss the coffee and Viagra for sure. I've been taking a mild anti anxiety med, Clonazapam , and that is not on the list of restrictions, anyone take an anti anxiety prior to the test, the anticipation of test results has me very anxious.

 

[Koolau]

there are two pages of restrictions and pretty sure Metroprolol is on the list, going to miss the coffee and Viagra for sure. I've been taking a mild anti anxiety med, Clonazapam , and that is not on the list of restrictions, anyone take an anti anxiety prior to the test, the anticipation of test results has me very anxious.

Check with your doc about being anxious. S/he might give you something that's specifically okay for the test. S/he might also "talk you down" about the test as it shouldn't be all that bad.

 

[braumeister]

So that begs the question, can I ask to go further or is protocol strictly followed unless stipulated by previous doctor clearance?

My actual max HR is way above the calculated number so I’m a real outlier. When I had a stress test some years ago they let me go a little above their number but not nearly as much as I wanted. They were still happy with the test so I think it’s not a big deal.

 

[MarieIG]

I had my first visit to a cardiologist last week (due to chest and left arm pain). They took my blood pressure, gave me an EKG, and a stress test. I will need to set up a patient portal to see if I can find answers to those questions but - before the tech started the stress test she asked about health conditions and ongoing treatments. I mentioned that I was currently receiving PT for bilateral hip arthritis and degenerative disc disease, and she mentioned that she was just going to do the test long enough to get the numbers that she needed so that I would not be in pain the following day. I felt that could have gone longer at the point when the test was completed.

 

[audreyh1]

My actual max HR is way above the calculated number so I’m a real outlier. When I had a stress test some years ago they let me go a little above their number but not nearly as much as I wanted. They were still happy with the test so I think it’s not a big deal.

I run way above my calculated max HR during exercise like strength training. This is normal for me and feels good. I’d have to slow way down to keep my heart rate lower.

Interesting to know.

 

[big-papa]

Dr. William Brewer demonstrated an at home plaque test. Obviously, this is not a substitute for, or meant to discourage visits to, your cardiologist. I am going to to try this over the next few days, and also inspired by this thread and some long standing - long ignored issues - will be following up with my PCP as well.

Update: I did try the "test" and obtained the following results:

Lt arm 94/65 Rt arm 95/72

Lft ankle 122/83 Rt ankle 120/77

end result was:

(left) 1.28

(right) 1.26

Thanks for this. On a lazy Sunday afternoon, my wife and I spent a few minutes doing this test on each other. Good numbers for each of us.

And if one is wondering whether this is just more internet noise, Stanford's website also shows this test as well, though they used ultrasound in their example of how to make the measurements (aimed at healthcare workers). Ankle Brachial Index

Cheers.
Big-Papa

 

[MarieIG]

I had my first visit to a cardiologist last week (due to chest and left arm pain). They took my blood pressure, gave me an EKG, and a stress test. I will need to set up a patient portal to see if I can find answers to those questions but - before the tech started the stress test she asked about health conditions and ongoing treatments. I mentioned that I was currently receiving PT for bilateral hip arthritis and degenerative disc disease, and she mentioned that she was just going to do the test long enough to get the numbers that she needed so that I would not be in pain the following day. I felt that could have gone longer at the point when the test was completed.

Update: I spent over an hour and a half creating a patient portal yesterday - including waiting on hold, and having assistance with a customer rep. I did see the test, and copied something from a summary, but when I tried to log back in, not even my e-mail was recognized and I could not reset the password. I copied a line from the visit summary before I found the test which read: EKG normal sinus rhythm within normal limits normal PR QRS and QT interval. Exercise stress test was performed today on September 3, 2024: The patient had an excellent exercise tolerance normal blood pressure response and no EKG changes.

I am not going to try calling customer service again for a few days. The whole experience gave me a headache.

 

[aja8888]

Update: I spent over an hour and a half creating a patient portal yesterday - including waiting on hold, and having assistance with a customer rep. I did see the test, and copied something from a summary, but when I tried to log back in, not even my e-mail was recognized and I could not reset the password. I copied a line from the visit summary before I found the test which read: EKG normal sinus rhythm within normal limits normal PR QRS and QT interval. Exercise stress test was performed today on September 3, 2024: The patient had an excellent exercise tolerance normal blood pressure response and no EKG changes.

I am not going to try calling customer service again for a few days. The whole experience gave me a headache.

Sounds like getting on the portal was a stress tests in itself!