deacon mark

Ok background. I am 55 and a long distance runner and cyclist for 39 years. Have run over 75,000 miles in life and cycled less but now ride 3k a year and run about 1500 miles. I have had high blood pressure since is was 14 years old, yes that young. Treated with meds these last 41 years and done ok. So I palpitations at times no racing heart but I can feel it beating. Heart rate is about 42 resting so easy to feel any disturbances. Well I had an EKG showed a little change a partial Right branch bundle blockage. This can be normal and is often seen in endurance athletes but since a change they send me to the Cardiologist. Lucky a friend and parishioner at where I am assigned. The ekg he did later did not show this and he said my heart was like many endurance athletes on paper.... but...

So he wants the whole work up. Eco-cardiogram, stress test, 48 hr holter monitor. I was nervous about this all shaking in my boots, no faith. Well I do the eco shaking on the table. They were not going to let me do the stress test my blood pressure was too high to start. Well the Dr said ok let him go 250 over 110 if more stop test. I go through the Bruce Protocol treadmill deal. Got to about 15 minutes stage 4 they ask how I am. Nothing too bad working but certainly could keep it up longer and go harder but blood pressure was 252 over 85 so they stopped it. They said is was diagnostic because my heart rate reached 148 so it was ok. I kinda of want to max it out and feel I could have had I not start with all the nervousness and mental stress. Humility is what the deacon needs right? The nurse practitioner said she was going make a note I was not really straining could probably done 8 more minutes. They would then go to 18% and 5.5 mph that I am unsure about.

My problem or ego was that I could have gone longer and at least stage 5 but the treadmill was on 16 % incline at 4.2 mph. To slow to run but to fast to walk very smooth. I don't know what it all means except now they have me worried because I hammer some hills cycling that are way harder than this stress test. In fact cycling up a long grade for a period is more taxing on my system than an all out 400 meter run after running a hard mile. I routinely run much harder and faster.

Maybe all this cycling and running is not so great. I frankly do it not for exercise I just like to run and cycle. I would like know of any of us older here who have done a stress test.

CrankyOne

Do you wear a heart monitor when you ride? About once a year my doc reviews a couple of my rides (one moderate, one strenuous) to see how I'm doing. He looks at the grade, how many watts I'm putting out, heart rate, etc. So far so good.

My doc is among an increasing number who think that too strenuous of exercise isn't necessarily good and can be bad, especially for people over 40. He's becoming a strong proponent of 30-60 minutes per day of moderate exercise which he describes as a somewhat brisk walk/hike or riding about 10-15 mph.

2 Piece

Oh, over the last 10 years about 6 nuclear stress test and just one ultrasound stress. No reason to stress over a stress test.

deacon mark

I wear one just for fun. Running my hr is 130-140 for typical daily 5-6 mile run. On the bike I find hr lower have really be trying to push pace to get over 130. It takes a sustained 20 mph pace for a long time to get hr near running. However a very steep incline can make it jump. Going up a ski resort 9% grade for a my hr can get to 153 by end.

DaveQ24

I've had them a couple of times - a decade ago as a prerequisite to a major surgery just to make sure my heart could take it, and about 11 months ago just to basically humor the cardiologist who wanted an age 50 baseline. Treadmill stress test and Doppler echo with (first) and without (2nd) contrast. Didn't find either round of tests particularly stressful physically or emotionally. I have a collection of various medical issues - asthma, knee on the way out eventually from RA, anemia, but a healthy heart.

Deacon - try not to overthink it and worry / easier said than done, believe me, I do that myself. At 55 you are so far ahead of the game compared to the average American that you could afford to ease off the intensity a little if you had to ... but be sure you get all of the facts from your doctor so you can make an informed decision on a rational basis.

It does appear that the scientifically-proven evidence is mounting that significant endurance training does cause cardiac changes that can be detrimental. The new thinking among coaches and trainers is "train smarter, not harder." Of course, there is controversy around it. I read a book called 'Beyond Training' by a trainer named Ben Greenfield back in November - made a lot of sense to me - but as they say, ymmv.

Rollfast

I got shingles in my right leg on Hew Year's Eve, I gather I have stress.

Biker395 

I've had a stress test. My father had heart issues, and in spite of the fact that they were almost certainly exacerbated by his lifestyle (2 pack a day smoker on one lung), I thought it best to explore it further.

It was rather easy for me. Like you say ... There are times I've pushed waaay harder on a bike. The doc had to remind me to stop talking and keep my mouth shut again and again. Finally, he switched it off and remarked:

"There's nothing wrong with you. You're fine."

I'm not sure what to say about your BP numbers. They sound really high, but I'm not a doc and I don't play one on TV either. I have no idea what is normal in that context.

One thing I finally did do is have a CT angiogram. That won't help diagnose a lot of heart issues, of course, but it does a good job at looking if you have congested arteries. My understanding is that a stress test only shows issues if the blockages are nearly complete (90% or so). Have you had one of those?

You're very right to be concerned about all this stuff. Keep at it until you get it resolved!

canklecat

Have they checked your neck? My BP is usually normal but occasionally spikes due to a damaged C2 (car wreck several years ago). It's uncommon and unpredictable. Last time was almost two years ago, hit 200/100, accompanied by a horrific headache. I have to be very careful of my neck alignment. I mean while sleeping, exercising, etc., not chiropractic stuff -- the C2 damage makes any neck adjustments too risky.

Since resuming bicycling in August 2015 my BP has been consistently good, but I have to avoid over-exertion and craning my neck. My bikes are set up with the handlebars at or slightly above saddle height. No drop bars or anything that requires looking up to see the road. I ride with reasonably wide, soft tires and one bike also has a spring suspension fork for days when my neck is aching.

And no jogging or running. Too much stress on an already damaged neck.

Rowan

The idea you wanted to max out on the stress test is irrelevant to the doctor. I think he saw what he wanted. Have you chatted with him about it, or are waiting for another appointment to discuss this?

My stress test was to see if I had heart muscle damage from a "heart attack" about 20 years ago. I was surprised to see how my blood pressure increased so substantially over the test (sorry, don't remember the numbers, but the upper was well over 200).

The heart specialist stopped the test before max and simply stated I had "blitzed" it; his conclusion was that my "heart attack" was indeed a case of broken heart syndrome, and that I could go on to a cholesterol medication, which I declined, but apart from that, everything was fine.

Fortunately, this conversation happened immediately on conclusion of the test. So there was no stress involved in waiting for results.

Mobile 155

I have had some of the same tests as the OP. EKG showed a Right Branch Bundle blockage and I was sent to an Cardiologist. I was riding 150 to 200 miles a week but wasn't feeling my best. I had several stress tests and even a nuclear stress test. Still was riding and scheduled a Angioplasty. I had some blockage but nothing serious till they found a abrasion one of the branches and I was sent the next day to another hospital and had quadruple bypass. Everything else was answered by the angioplasty and just so you know the recovery takes a lot longer than they tell you.

Your results may be different.

2 Piece

I was just getting ready to post that stress test are not all that reliable at showing heart conditions or blockage and Mobile 155 posted and beat me to it. Get a angioplasty to make sure.....but they are pretty expensive. I actually found the recovery after angioplasty to be almost non existent, and not to be confused with bypass surgery which will take a long time for recovery.

deacon mark

I go back in two weeks for follow up. I assume if the eco-cardiogram I have before the test would have been abnormal they would have not had me do the stress test. I have one kidney test tomorrow too. One thing I have always had great cholesterol numbers. Mine were 168. The others all excellent do not remember the others but the they are ok. I will take what I can get.

Darth Lefty 

I had a stress test when my heart condition was first diagnosed. It was the first thing the cardiologist ordered on the first day I saw him. My heart condition is probably unrelated to yours, but I know for sure there was no reason for me to hit full exertion in order that he see my condition. In fact on the day of the test my condition didn't bother me. I was frustrated by that because I wanted to prove it was a real problem, but he saw it just fine in the picture. I also at one point had a bike stress echo, I can't remember why, that was supposed to show the heart during exertion rather than just after. Probably I had told the doctor I was feeling worse than he believed. But it was a stupid fiasco. The pedals were in the air at the bottom of a bed so the patient would shift up and down as he pedaled and the echo tech couldn't see squat. I suspect there is a better version of this rig and their hospital just didn't own one.

BlazingPedals

After I told my (ex) doc that I refused to take statins anymore, he insisted on a stress test. Probably to 'prove' that I was going to die. I don't know if I got the Full Monte, but he was listening to all the valves and arteries as he ran me up to 150 bpm. Nothing found. I asked if, since we were close, we could go the rest of the way to see what a good max was for me. He just gave me a sour look and said something about wearing out the equipment. Watta grouch!

Since there are lots of docs in my bike club, I once asked one of them if I should be getting one regularly. He just chuckled and told me every bike ride I did was a stress test.

FlashBazbo

I would relax about the stress test. I have had one nuclear stress test and, I have to say, it was pretty anticlimactic. I was actually disappointed. Not much physical stress at all. I could have gone much farther, harder, faster. (There's a little bit of the showoff in most athletes.) But they didn't need it to see what they needed to see. That's the point of the exercise, after all.

10 Wheels

Took one when I was 73 y/o passed it. No big deal.

a77impala

I had a nuclear stress test 12 years ago when I was having chest pain. Passed wth flying colors, pain turned out to be side effect of a prescription drug I was taking. No pains after stopped taking drug.
Last February I had one in ER after suffering suspected heart attack. Passed again, no heart attack, doctors said maybe indigestion! LOL
I'm 72 with no heart history in family. Ride 6,000 plus miles a year.

DaveQ24

I don't think you can make that assumption. Based on my knowledge - strictly as a patient - they generally order those two tests together. Both times I had this battery of tests done, they were ordered at the same time.

The purpose of the echo is to show the structure of the heart, particularly the valves and chambers (at least that is what the technician that did my last one was concentrating on) and to get bloodflow numbers (the "doppler" part - it was pretty cool actually on the monitor). The treadmill test is measuring the electrical activity in the heart from resting to stressed under a workload. At least that is my purely amateur, uninformed take on it.

Again, you need to not stress yourself out more by worrying - easier said than done, but try not to worry.

Rick@OCRR

I had to have a stress test on a treadmill before they (Kaiser Permanente) would let me out of the hospital after a suspected (but not actual) heart attack.

I had spent the whole night in a room off the ER and I was anxious to get out of there. I easily hammered the test; kept asking for more angle and more speed but the cardiologist stopped me when my heart rate hit 165.

He told me I should keep riding but to limit my heart rate to 165 maximum. Which I have done (mostly) ever since. The good news was that he signed my paperwork so I could go home which was my goal at that point! 20+ hours at Kaiser is not fun!

Rick / OCRR

RonH

I inherited my dad's bad heart. He had his first heart attack at 53. Had 3 more before he was 60. He never quit smoking so died of cancer when he was 71.
I've had a couple of stress tests because of heredity. The cardiologist found a 90% blockage in the LAD artery in 2014 after I complained of difficulty breathing when climbing easy hills. They put a stent in my LAD artery. Haven't had any problems since. I have my yearly stress test later this month. Here's hoping all is well.
BTW: I'm 72.

CV-6 

Stress test abut five years ago for a right bundle branch block. I had the same issue you did with the treadmill being at a walk or run threshold. Passed test with flying colors and last ECG did not show previous issue. Don't worry about it.

MinnMan

I've had several stress tests, one of which made me very angry for reasons that have some *echoes* to the OP's story.

I was having issues with my HR - when I redlined, I could not recover. I previously had a RHR (decreases in HR 60 seconds after being up in Z5) of about 35 or 40,and all of a sudden one day it was 12 and I just couldn't keep up with my friends if I let my HR get too high. Doc says, have a stress test. This test was the type where you lie down and pedal a stationary bicycle. I go in and the tech announces that we'll go to a HR of 148 because that's what's needed for a person of my age. I replied that my MHR was/is 180 and that I didn't see the worrisome behavior until my HR gets up to 170 - (after all, I wear a HRM and I know these things very well). She argues with me - "148 is all that is medically necessary according to the guidelines". I say, then the test will be pointless, etc. She says, OK, suit yourself - we'll go until you are ready to quit. I start the test, we get to a HR of 148, and she announces that the test is over. I responded by sprinting and quickly got up to the high 150s, and then they stop taking data! She says, "you shouldn't complain, lots of people your age can't get their HR above 150 on these tests, it means you are very healthy. (as if MHR had anything to do with health - what with Chris Froome and his MHR of something like 145?) " THEN, she had the nerve to record that the test ended because of patient exhaustion!

The doc was annoyed too, and sent me for a second test - this time a nuclear test on a treadmill. But I don't think that the tech suffered any consequences.

canklecat

Ditto, when I was 40. Sudden onset of chest pains and shortness of breath from minor exertion, like walking up a single flight of stairs.

Spooked me because both sides of my family did have some history of cardiopulmonary dysfunction, ranging from a cousin who died of a heart attack at age 40 with no prior warning signs, to strokes and congestive heart failure.

Turned out to be side effects from a prescription med I was taking to help prevent migraines. So I discontinued that med. The next med intended to relieve migraines once they'd started, Imitrex, had the same side effects -- chest pains, shortness of breath, racing heart, pounding sensation in my ears. Had to stop taking that one as well.

My HMO plan doctors were pretty much useless during that period. I didn't get a straight answer until my insurance changed and I saw different doctors.

It's also a bit disconcerting how some medical professionals are unaware of, or unconcerned by, side effects and drug interactions. It shouldn't be necessary to consult multiple doctors and health professionals to get an informed answer or at least a suggestion to narrow down the causes.

icyclist 

Deacon, what is it you want to learn? Yes, lots of people have had stress tests. Are you asking people here what you stress test means about your health? Did you or did you not get your test results back from your cardiologist, and if so, what were those results?

By the way, if you don't know this already, here's a truth: while you can "flunk" your stress test, it's possible the result is a false positive. That's one reason everyone doesn't get a stress test. There'd be too many false positives. There has to be a good reason to have the test.

Because I flunked mine, I had an angioplasty, which ended as soon as my cardiologist could see the stress test got it wrong.

Just because you have skipped heartbeats doesn't mean you're going to drop dead on a bike ride. Results of a stress test aren't set in stone, either.

So tell us what the results of your stress test were and maybe some people here can offer some advice based on personal experiences.

a77impala

I gave my doctor the names of the drugs I was taking, had he researched them I could have avoided the stress test. I found the contraindications on the internet!
That doctor retired and I told my new doctor I had this happen and he said he could prescribe something else, I declined and have lived without since!