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Forum Name: Cardiology Diagnostics

Question: My stress Echo


 Celeste012 - Sun May 15, 2005 11:13 am

:?: I have a question that i would like some help with. I am a 32 year old woman with a hx of shortness of breath and multiple PVC episodes. My dr sent me for a stress echo and since i used to do cardiac telemetry the clinician who did my stress echo after was quite candid with me . he stated that my ecg part of the test seemed normal yet my echo part showed a "sluggesh" part of the left ventricular wall.this was after the stress part had finished. he said that it was clearly visable on both windows and showed it to me. now being from the field im no where nearly as edjucated asthe cardiologist however i know that could be indicative and i stress could not that it is to an artery problem. Now here is my question.. When I was in the hopsital recently. i was given some medication that hardend the veins where the medication was administered and traveld all the way up to the shoulder. There isnt any way that this medication can do this anywhere else in the body is it?

The Dr. asked me if the palpitations i had comboned with the sharp pain and nausia was when i was exersising. I thought that was funny because i get short of breath as soon as i hit a flight of stairs. so i said No its only when i get up or if i get starteled (sp).. When i was hospitalized 2003 for the same thing the noticed that the enzyme in the CPK panel that shows muscle damage or harm was elevated yet they never took it any further they said that it was insignificant. since then i have had this problem. Could you please sshed some light on what this all could mean? Thankyou
 Dr. Yasser Mokhtar - Wed May 18, 2005 5:34 pm

User avatar Dear Celeste012,

If you don't have any major risk factors for coronary disease including hypertension, diabetes, family history of early coronary disease (in first degree relatives), high cholesterol, smoking, being above 50 (in males) and 60 (in females) and being a male.

Females of the child bearing age are naturally protected from coronary disease unless they have had major coronary risk factors for many years.

What kind of stress echo was it? Was it a treadmill or a chemical test? If it was a treadmill, how long did you stay on the treadmill and did you reach your target heart rate?

i can't judge what your cardiologist saw but i believe that he saw something. What did he decide to do regarding this, did he want it pursued or he thought it is not significant?

Seeing an abnormal motion on the echo after stress could mean that you have coronary disease or a false positive result.

Being short of breath when climbing stairs or when performing any exercise could be due to many causes starting with being non-fit physically and ending with heart failure or lung failure. You have to have a regular echo to check for the ejection fraction of the left ventricle (how well the heart contracts) and rule out diastolic dysfunction (abnormal relaxation of the left ventricle).

If you don't have any major risk factors for coronary disease, i don't think you should be worried especially that the symptoms that you are complaining from are atypical as compared to the symptoms of coronary disease.

Regaring the cpk, it can elevated from many things as well. There is another enzyme that is now usually tested called troponin that is most people consider far more important than the cpk.

i can' t really tell what is the vein hardening medication that you took and what is its effect unless i have its name.

Thank you very much for using our website http://doctorslounge.com and i hope that this information helped.

Yasser Mokhtar, M.D.
 Celeste012 - Wed May 18, 2005 6:34 pm

I hope i can remeber all that you asked but i will give it a shot... My Father has hypertension,cad with a pretty high percentage of blockage. he has had this problem for the past 20 yers hes now 64. My mother im not sure about only because she refuses to discuss it.. I am a fit 32 5'7" 145lbs woman. The shortness of breath with sharp chest pain and nasea only happens when i get startled if i jump up quickly or if i lean foward or sit up from a flat position. The shortness of breath also will happen suddenly if i stop moving (like climbing stairs). I had a normal echo wich stated that i had minimal regurgitaion in th e mitral tricuspid and the Pulmonic was not well visualised the left ventrical was at at 58% if that makes sense and right was greater than 60% The stress test was on a tread mill i went about 9 minutes and my heart rate was right at about 168 beats. I have not heard from the Dr. yet so i am just waiting to hear from him. I am a normally healthy person other than this heart problem lol this whole thing started in 1992 when i had passed out while at work (ironically a hospital) when they hooked me up they noticed that the heart was beating very fast and having pvc episodes. they werent able to figure out what it was but showed some concern due to being tachicardic with heart rates at 170 ironically wich is the same thing i am going through now. and last year... I am pretty sure its nothing i think its the jolt in he chest then trying to keep from fainting scares me. Thankyou
 Dr. Yasser Mokhtar - Wed May 18, 2005 7:30 pm

User avatar Dear Celeste012,

Thank you very much for the update.

The story now is totally different, i think you should be seen by an electrophysiologist if you were not already seen and evaluated by one, these episodes of tachycardia leading to syncope have to be evaluated. i think something else has to be looked for and not coronary disease.

If your syncope was not worked up, i suggest that it should be.

Thank you very much for using our website http://doctorslounge.com and i hope that this information helped.

Yasser Mokhtar, M.D.

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