I went to the doctor (a new doctor, aiiee!) with chest pains. Throbbing chest pains with my heartbeat that seem somewhat dependent on the position of my body. For example, if I lift my arms up over my head, it’s extremely painful.
This week, I’m scheduled to have a “heart echo” run. I’m assuming they aren’t too worried since they didn’t stick me in the hospital or anything, but what sort of thing might the test be looking for? I hate not having the answer, but the doctor didn’t explain and, frankly, almost seemed to be avoiding me. I must have cooties. (And I’m going to go doctor shopping. Again. sigh)
I had one a few months ago because I was having chest pains and I have Mitral Valve Prolapse and a strong family history of Marfan’s Syndrome.
You run on a treadmill until your heart rate reaches a certain point for a certain length of time, then practically run to lay on a table so they can do an echocardiogram. My doctor didn’t go into detail about it, either, but he did point out to me on the screen that he was looking at how the blood goes into the various chambers of the heart and the circulation.
Sorry I don’t have more to tell you, but I do hope you find the cause of your pains and it’s nothing to worry about.
I lasted 11 minutes on very high speed on the treadmill, so prepare to get a fairly good workout.
Caveat: IANAMD. A “heart echo” is an echocardiogram, and you can Google that, but essentially a picture of your heart’s actions are formed from ultrasound waves. These waves depict the movement of your chambers, blood flow, valve action, etc. It, by itself is not a stress test, as described by trublmakr, but, I guess, it could be conjoined with one. The way she described it sounded like a thallium stress test, but in that test, thallium is injected so that a radiograph of your coronary arteries can be taken. The radiograph is taken immediately after the treadmill and again several hours later.
Actually, this is not quite correct. With a stress test, you walk on a tread mill untill (if you’re capable of it) your heart reaches a certain rate, calculated based upon your age. When you reach this point either thallium or more commonly Cardiolite is injected into an IV line. You’re than asked to maintain the same pace for about another thirty seconds. What happens is that the thallium and/or the Cardiolite is taken up by the muscle tissue in the heart. If a cardiac artery or arteries are blocked that portion of the heart fed by those arteries will show appreciably less uptake than the portions fed by healthy arteries.
The heart is imaged by use of a gamma camera which detects and records the distribution of the tracer. A computer than reconstructs an image for the doctor to look at.
I know this stuff cause I’ve worked on gamma cameras for almost 20 years
To get a radiograph of the coronary arteries a heart catheterization needs to be done. Radio-opaque contrast media is injected via a catheter, which is usually threaded up from the groin. This allows the cardiologist to spot and pinpoint ischemic regions. The stress test, described in my previous post, is usually used as a screening tool to determine if someone requires a cath.
An echocardiogram is just an ultrasound of your heart. It tells you:
–a general description of your heart anatomy. Size of the chambers, thickness of the walls, etc.
–how the heart is moving. Are parts of it not moving (like you might see after a heart attack)? Is the whole thing moving poorly, like you might see with a cardiomyopathy? How much blood is it pumping out with each beat?
–how blood is flowing through the valves. Are valves too tight, or are they leaking?
Those are the basics. It’s a very general test, and I don’t know what he’d be looking for specifically.
A regular echo looks for heart muscle contractility and valve function. It’s a nice, non-invasive test. It may also look for inflammation or fluid buildup around the heart.
A stress echo is done while exercising hard, so the heart contractility and valve function at peak (or near peak) exercise. It’s a little awkward; exercise to about 90% of predicted max heart rate, and jump off the treadmill or bike, and get the echo done. Resting echo would then be compared to stress echo.
Nuclear stress echo combines the fun of a stress echo with an injection of radioactive material, so that heart pumping action can be better evaluated. Pedal hard, get an injection, keep pedaling, have the nuclear camera put on your chest while pedaling, snap some pics, get off the bike and go for the echo.
A regular stress test is where you get an ekg, then walk on a treadmill and as your heart beats faster and faster, more ekgs are taken. If part of the heart muscle has reduced blood flow to it during exercise, this may be reflected by ekg changes.
A nuclear stress test combines the above with a radioactive injection during peak exercise and pictures of the heart immediately after exercise and a few hours later after resting up. If parts of the heart muscle don’t take up as much radioactive material right after exercise as they do in the resting pictures, there may be problems with blood flow to that area.
None of these tests directly measures coronary artery blockage, but blockage may be inferred in some cases based on test results.
Of course there are also adenosine nuclear resting stress tests, dobutamine nuclear resting stress tests with atropine if you’re unlucky), and the old persantine nuclear resting stress tests associated with a high degree of barfing.
It turns out the question ended up moot. I went for the test and they said that I wasn’t scheduled for an echo but for an EKG, regardless of what it said on my paperwork.
So I had an EKG instead. Normal heartbeat aside from being really fast.
When I got there, it was 103. At the time of the EKG it was either 96 or 94. Thirty minutes later, it was 120. Thirty minutes after that it was 88. So it was jumping all over the place. I’m not sure where the medical term “really fast” would start.
Very coincidental that I saw your thread considering I just had the heart echo run on me yesterday. My family doctor noticed that I had heart palpitations while doing a routine physical and recommended I have the echo as a precaution.
The echo tests your heart while resting versus while under physical exertion and compares the performance. It measures the flow of blood to your heart and can determine if there is any abnormalities or blockages. They will view your heart with a scan, similar to viewing a baby in the womb. It’s kind of wierd to look at your heart beating on the screen. They first view it while at rest then again after you taxed from the treadmill.
They hooked my up with a bunch of nodes/wires on my chest and around my rib cage area. I have a lot of chest hair and they had to shave a few bald patches to stick the nodes to my skin(I consider the bald patches a new fashion statement).
They run the EKG line while you are on a treadmill. Gradually they will increase the level of exertion until you get to “very hard” on the exertion scale. For me it took 14 minutes with the treadmill on 5 and a 14% incline. I’m in pretty good shape from working out and playing tennis. Most people take less time to reach the stressed level, or so they told me.
During the run/walk on the treadmill they will take your bloodpressure and enter the data into the computer model they are running.
I wouldn’t worry about the test itself, just be sure to wear running or walking shoes and sweats. If there is a problem with your heart there is a 99% chance the test will pick it up. Good luck.
A really fast heart rate (tachycardia) is not normal. Could be a normal variant, but really fast??