During a recent physical, the doctor recommended that I have a stress test. He said he noted what appeared to be some minor abnormalities on the EKG this yr. versus last. he said it was probably nothing but given my family history he would recommend a stress test. I have never had one and am somewhat anxious about the test. I have talked t0 a couple of friends who have had them and although they assured me it is nothing to be too concerned about, I am more anxious than I thought I would be. I guess one piece of good news is that the doctor told me I could continue my normal exercise routine prior to the test. Anyhow, tomorrow is the day one way or the other.

Has anyone who has gone through this got any advice or information on the test? How did you feel during/after, what I might expect, etc. ?

Never had one but FIL had regular and nuclear with no issues even after triple and quad bypass.

Good info....https://www.nhlbi.nih.gov/health/heal...ss/before.html

Good luck and relax.

I had one last year and looked at it as a challenge. Some background: I had a minor heart attack in 2000. They can't fix what is wrong so I just live with it. My first cardiologist wouldn't tell me what I can get my heart rate up to safely so I just kept increasing it until I felt chest pain. I kept asking for for a stress test as when I feel pain and when my heart starts having problems could be two different things, but no go.

Finally last year I felt some chest pain during a ride and went to the ER. They ran a bunch of tests and said it wasn't my heart. The test include a stress test on a treadmill. They only let me go to 140 bpm which is 85% of their guestimate of my max heart rate. I was still feeling fine and had plenty in the tank at the 10 minute mark. I wish they would have let me go to exhaustion or when my heart started acting up.

As for the test, they put on the EKG wires on my chest and put me on a treadmill. Started out in a slow walk and about every 3 minutes they increased the speed and/or raise the incline. At the 85% mark they stopped the treadmill and made me lay on a table to do some quick tests.

Besides riding I also do a lot of distance walking including half marathons. I think this might have helped me on the treadmill; however, cycling is good cardio also and should help on the test.

you are stressing over a stress test. then consider the day before part of the test. what are your techniques for dealing with stress? friends to talk to? exercise? relaxation techniques? meditation? distraction? work the problem.

If worse comes to worse, I had a stress test that led to a cardiac cath. Piece of cake. I wish I hadn't been so apprehensive.

It's normal to be apprehensive about this sort of thing.

The stress test is not bad, though. In all probability, your doc has ordered a nuclear medicine stress test. The objective of the test is to check and see how well your heart muscle receives blood flow. What they do is inject a special dye into a vein, and then take a series of pictures with a nuclear imager. The dye is mildly radioactive, so they can see where the dye (and thus blood) has moved into the heart muscle itself. Then, they will exercise you on a treadmill to take your heart rate up to a set goal (there is a formula they use to determine what heartrate must be reached) while they have you hooked up to an ECG machine. After the exercise, they will take another set of images and compare how the blood is distributed in the heart muscle.

Depending on your weight, they may do the first (resting) set on images on one day and the exercise set on another.

Apart from the IV, none it hurts, and you are closely monitored during the exercise phase. There are no residual effects from the dye or the testing, you can go back to your normal routine right after the testing.

Matt

Did you ask what the minor abnormalities are?

I grew up in the decade of "question authority". It's served me well throughout life. I hardly ever take anything at face value. I nearly always ask for more information. Especially with medical matters.

Heart trouble runs deeply in both sides of my family. I signed up for a clinical trial a few years back. As part of the qualifications, they gave me an EKG. Noted a minor abnormality. So I asked, "What's the abnormality, why is it minor, and what does it mean for my health, well-being, and lifespan?"

He explained, then re-ran the test to show me in real time. That put an end to my apprehension--in only five minutes.

Always question.

I had a stress test a couple of years ago. For mine, they put me on a treadmill, and asked me to trot on it, while they made it more and more difficult. To be honest, it wasn't all that physically tough at all. I ended up pissing the doc off because I was (nervously) chatting with him while taking the test itself. He had to keep telling me to shut up (politely of course).

Did you ask him why he suggested the stress test? I'm obviously not a cardiologist, but my understanding is that if congestive heart disease is the fear, there are other tests that might be in order.

I stressed about my stress test too. But it turned out to be easy. They put me on a treadmill and over time increased the incline and the speed. But I never got past a fast walk. If you bike or do other exercise with any regularity, you shouldn't have a problem with the stress test. When it ended I was just getting warmed up. The only thing I didn't like about it was getting sweaty.

I hope the test has good results for you.

My doc recommended one as I approached 50, knowing that I like to ride and push myself fairly hard. The test itself was pretty much a non-event - get hooked up, jog on a treadmill for a bit. No worries, no stress.

For me the kicker was the next day, when my doc called me and said they'd found some abnormalities and I was to report to the hospital IMMEDIATELY. Spent two days getting tested before they determined that it was a false positive. Now THAT part was stressful!!

Good luck.

Steve Z

Most riders here would have little difficulty with the stress test. Heck, our normal training rides are way tougher.

Maybe the more difficult aspect is dealing with the unknown/unforeseen "what ifs" associated with an abnormality. As others have suggested, try to remind yourself not to be anxious. Be thankful for the routine access to medical care and tests. Ask thoughtful questions. Talk with wise friends close to you about your options. Relax and have faith.

Let us know how it went.

Phil

I had my first one this past Feb. The GP sent me to the heart doc. The heart doc said why are you here and I said I don't know. Ever had a stress test no, well let's do one. Worse part was drinking all the water to flush out the necular die. Was peeing every 10 minutes. You have to lie still for 15 minutes of picture taking as the die flows through you. I had not been riding much because of the cold weather and had switched to the elliptical for my workouts. Doc had to run me for 11 minutes to reach max heart rate. I know what this is now, wear a heart monitor when I ride and no longer feel guilty about only averaging 12-13 mph on my rides. Was good when the heart doc said you have no blockages and are in good shape. I was thankful I had started taking a low dosage of Lipitor some 20 years ago or things could have turned out different. I looked at the stress test as a challenge. As I was sitting in the office a guy came in for the stress test. He said he was retired, his exercise was channel surfing, and he was 30+ pounds overweight. I figured the doc would run him into the ground in two minutes.

This turned out to be the limiting factor on mine. It was in a rather small, warm room with no fan and once I got warmed up I started sweating enough so the electrodes wouldn't stay on. They decided that they already had enough data to say things were fine, but I would have preferred to have the test continue until I had to stop from exhaustion since I felt I could have kept going for awhile.

I have had several, due to history of MI. They take me to 160 and the hardest part is that my leg muscles start to protest from the unfamiliar stress. My cardio handled it well, but that comes from conditioning my legs to go in circles. If you are concerned, spend some time walking briskly. I don't jog out of concern for my old joints.

I have had several due to family history and some chest pains. What the others said pretty much sums it up - go on a treadmill till your heart rate gets pinned - hold for a few minutes - then they may do an ultra-sound as well as check EKG values. If you have one with nuclear die - you get this instant sensation of warmth and flushing.

The nuclear one will be able to show a lot of details - but I doubt your doc would send you for one of those yet - unless the 'regular' stress test came back suspicious. Keep in mind that a a stress test is limited in showing blockage. But a very good, non-intrusive test would be a Calcium Stress Score. This shows if you have any calcified plaque in your arteries - and from the level of calcification, a doctor can determine what level of blockage someone might have, what your risk is, and what you need to do about it. I've been fortunate that my best friend from college is a cardiologist, so I get these every 5 years for free (though with insurance, it would only be a few hundred dollars, but well worth it). According to my friend, he's seen many people have near perfect stress tests, but wound up being at risk of a heart attack due to the amount of plaque - as detected by the Calcium Stress Score. Google this to find out more info and then check with your doc. It's becoming a more proactive way of monitoring heart health by cardiologists, and is minimally invasive.

Good luck with your test!

I've had chest pain. EKG showed some abnormalities, but after going through this with multiple Docs, it seems many people have "abnormalities" and it doesn't necessarily mean anything. I've done 2 regular stress tests and one chemical. The chemical one was kind of scary, as you are laying on a bed and when they inject the chemical, it suddenly feels like you are doing an all-out town line sprint. The regular tread-mill test I tried to max-out, but I'm not in the same shape I was back in my heavy running days so I didn't do as well as I thought I should have. The hardest part is they want you to tell them just before you blow up so they can inject the tracer and you still need to go for another 45 secs or so, so the tracer gets to the right places.

So the tests themselves weren't that big a deal, but there was the hanging-around waiting to get imaged after recovery. Also at least where I was the imaging required maintaining absolute stillness while the camera cycled around.

After all that they never could see any problem. Eventually I got a different internist and he thought the problem was actually injured chest wall. He had me stop all exercises (I did a lot of weight lifting) for a year and that has pretty much cleared it all up. Now off the beta blockers, aspirin, etc. Had to work up the cycling again from zero, and weight lifting. Now I only lift what I can 12 reps of in a set. That also helps with the joints which just can't take the heavy weight any more.

scott s.
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I've had several. When I was in good shape, they put the treadmill at a high speed until my heart rate got high enough, but when I was in less physical condition we just walked. No problem with it, they monitor you and never give you more than you can take. Nothing to worry about. I had one time where they just walked me up and down the hall. The person holding the BP monitor had a hard time keeping up with me and I had a hard time getting my HR up high enough.

I doubt that there is really good data showing a stress EKG is better (makes you live longer or less likely to have MI) for athletic bike riders-than just a history-
"do you get chest pain while riding-at what HR"
On the bight side it is cheaper safer less invasive than a catheterization.

If you have EKG changes under load/exercise it means you have a fixed blockage of an artery.
Sometimes these fixed blockages will cause chest pain-but chest pain isn't always chest pain-especially in women-unclear why.

It DOESN'T mean you will have an MI- old fixed blocks are usually stable-don't suddenly break/lift up-clot off>MI-they can but usually don't
New "lesser obstructions" are more likely to break-lift-clot obstruct>MI
The stress EKG can't tell old plague from new plague-a catheterization "Might" be able to tell older smooth plague from newer less smooth plague.

In any case-don't worry.What you doc saw-extremely common as people age.
You are exercising- have good BP- decent lipids levels- eat right- and have plenty of cardiac capacity -
if you ever have chest or upper digestive pain pressure burning arm pain odd feeling something isn't "right"- head to ER- heart burn can be MI
Now not a bad idea to take 81mg aspirin a day-small bleed risk-but decrease MI risk...so
Yeah your heart is plenty good-this is strictly hunting for potential problems that would be relatively easily "fixed" at your leisure.
Luck
Charlie

So? How did it go?

I had a stress test about a decade ago. It was boring. They stopped the test before I even broke a sweat. No problems detected.

First, let me thank you all for the information and the positive reinforcement. I had the test today, it was the one with the nuclear dye, pictures etc. When I finally did the treadmill the nurse said they wanted to get my heart rate up to 132. I often hit that on the bike so no problem. I actually hit 150+ before I asked to stop. As I was working it, there was a nurse and two techs present. Hooked up to ekg machine and blood pressure cuff, that pressure was monitored several times during the test. I would say I exercised to my limit, and when through the nurse said "you did really good". Not sure what that means, the results will be sent to my doc tomorrow and I will call him. By the way, the test was done at Mass. General Hospital and the staff there was communicative, professional and friendly, they put me at ease and made the process painless, so to speak. Hope my doc agrees that I did "really good".

Good luck Timtruro. I'll say a prayer (non-denominational of course) for you.
Charlie

I've done two this year and was disappointed to learn they are looking for EKG data that points to problems and that information is obtained well below an exercise level that is a stress for me. A stress test may be hard for somebody in bad physical condition but I regularly push myself as hard (and harder) than I got to in my stress test. I'm doing a follow up stress test today after a stent was put in last week. They asked me to not eat for 4 hours prior to the test and I finally got them to explain it was because some people threw up. I laughed. It's just ten minutes of a hard effort. Today's goal will be to get them to let me continue pushing to a real, stressful, maximum effort and for me that is WAY beyond the point where they normally stop.

I had one several years ago, and found it not particularly stressful. It wasn't useful for setting or understanding HR zones. I later found they only take you up to about 90% of your "standard" maxHR, and at that time I had observed (with a monitor) heart rates above that. The purpose was to assess heart and cardio health by observing the system under a known level of stress, not to tell me what my LT is.

I'd say it's 10 minutes of good effort, not that hard. For a cyclist. When I was a couch potato, it would probably have been tough.