My husband was diagnosed from an EKG (at rest, no exercise) with Premature Ventricular Contractions (PVC). Tomorrow is a stress test, which we were told does not involve exercise, but involves injecting him with something and then following it somehow as it travels through the heart. The process takes 3-4 hours.
He has no other symptoms (I was there when the doctor interviewed him about this, and really he has no symptoms beyond the EKG) but he is nevertheless somewhat stressed about this diagnosis, and the fact that the test takes so long.
So can someone describe to me what the test is like for the testee? Does it involve just sitting around and having periodic scans of some kind, or does he have to sit in front of a machine the whole time? The doctor called it a stress test and he said it does not involve exercise, but every source I look at online talks about recovery from exercise. Thanks for any information.
Not an adult doctor. Just looking up on resources easily available to me.
Yes laying around while they measure during the infusions. May have some discomforts?
“The most commonly reported side effects of vasodilator agents are flushing, chest discomfort, headache, nausea, dyspnea, and, less frequently, atrioventricular block. These symptoms are generally transient and resolve quickly after discontinuation of the agent, particularly with adenosine due to its short half-life.[10][11] Dobutamine infusion may cause palpitations, tremor, anxiety, headache, nausea, and chest pain.”
That resource states generally pharmacological stress testing is recommended against for asymptomatic PVCs at rest. Unless unable to do an exercise stress test for some reason. I do not vouch that such is accurate but wonder what our adults docs here think?
It seems to recommend prolonged EKG patch to gauge frequency and an echo to start. Maybe a cardiac MRI if it is an uncommon location.
Specifically they say
In many cases, the most useful contribution a physician can provide a patient with PVCs is reassurance. In considering whether additional management beyond reassurance should be pursued, 3 key pieces of information are needed: (1) information regarding symptoms, (2) the burden of the PVCs (typically reported in PVCs as a percentage of all beats), and (3) the presence or absence of structural heart disease.
If the burden of PVCs is low, the evaluation as described earlier reveals no relevant underlying condition, and the ejection fraction is normal, reassurance alone may be reasonable and sufficient.
But not my field!! We have people here who will be much more informed
I had the stress test shot. They warned me I would feel very agitated and odd for a short time. Yep, I did feel very odd while they did the ekg.
They made me wait an hour before going home. IIRC they did another ekg or something similar before leaving.
It’s been almost 10 years ago.
My biggest surprise is how much the in home monitor has shrank. It was a box with a shoulder strap 10 years ago. I wore it 5 days. That box must have weighed 3 lbs.
Had that monitor test again in 2023. It was a little 1 1/2 inch square block stuck to my chest for 5 days. I had to return it to the doctor and they read the data.
There are different sorts of stress tests. You might walk on a treadmill or you might be given an injection if for some reason you shouldn’t walk ( like my husband had when he was getting the test prior to a hip replacement)
There’s a stress test that simply involves an EKG, but if he was told 4-5 hours , my guess is that it’s a nuclear stress test. That involves an injection of a radioactive tracer, taking “pictures” of the heart ( I’m not sure if it’s X-ray, ultrasound or what) exercise/injection, then another injection of tracer and more pictures. They always tell me to plan to spend 4-5 hours but it’s never taken me more than three.
That’s good to know, and thanks for relating your experiences. There’s no reason my husband wouldn’t be able to walk, but I think this is the nuclear test.
Is this kind of testing something that you’ve had to do more than once? How often?
I do it every year or so - but I’ve got coronary artery disease and have two stents. The reason for the stress tests is to see if there are any more blockages.
Good luck, Roderick_Femm, I’m sorry you and your husband are having to go through this. I can’t shed much light on the non-exercise stress test, but others above have done so. I can tell you that PVCs by themselves aren’t usually a big cause for concern.
Years ago we used to watch EKGs like a hawk to see those dreaded Premature Ventricular Complexes (though we always spoke sloppily and said “contractions” instead of “complexes.”) ready to medicate if we saw them.
Thank goodness by the time I started having my own, the thinking had changed. I have them individually, but also I often have enough of them together to be called “runs” of Ventricular Tachycardia. I see a cardiologist every couple of years, and every couple of years he asks me about them, does another EKG and tells me to go away.
Keep us apprised, will you? I hope it goes well and isn’t too uncomfortable.
I had one, maybe a year ago. Couldn’t do the exercise version because I’d injured my foot not long before, so I did the chemical version.
It wasn’t that big a deal. A lot of waiting around. Occasionally I’d be asked to walk up and down a long hallway once or twice. The scans themselves (before and after the heart-racing drug if I recall). And the drug itself, maybe 5 minutes or so of weirdness, heart racing but not all that much. Really less of a big deal than I’d expected.
I was diagnosed with atrial flutter over 10 years ago. (A cousin to AFib.) I think PVCs are part of the deal, though more transitory. Back then, I wore the big Holter monitor as described above. Now it’s much less annoying though worn longer. I wore the Zio patch thing for a week or so. Mildly annoying to shower around but otherwise no biggie.
Anyway, I’ve been taking beta blockers for years, and they control the heart palpitations for the most part. I still get them from time to time, but not all that often. Surgery (ablation) is an option but I don’t think it’s bad enough for me to choose it.
Yes, I was diagnosed with atrial flutter about 3 years ago, they did a cardioversion* and it seems to have disappeared. I am still taking a beta blocker. PVCs were not mentioned in my case, it was just a fast and irregular heartbeat. I had forgotten about it, but now I recall I did wear some kind of patch monitor for several days before the cardioversion
My husband’s test lasted 3 hours, he thinks it might have gone quicker but the nurse told him they had overbooked and apologized for making him wait. They didn’t provide any conclusions from the test yet, I presume that will come after the ultrasound thing next week.
*under sedation, they gave my heart an electric jolt or two.