My Heart Issues: Stress Echocardiogram Referral & Worries

[chroot]

I've been having some problems exercising recently. For the last six months or so, lifting weights (10-12 sets of 4 or 5 basic exercises with moderate weights) has often resulted in my heart rate staying at 160 bpm for half an hour, plus the added fun of cold, clammy hands, dizziness, and even ringing in my ears that persists long after I get back to my desk.

The doctor hooked me up to an ECG and, within minutes of seeing the printout, had a referral written up for me to see a cardiologist at the hospital to get a stress echocardiogram. I heard him outside the door telling the nurse to fax the ECG and "push me through" immediately, because he wanted the test "done in the next 48 hours." He checked the "urgent" box on the referral form. When he came back into the examining room, he asked me if I had ever had an ECG before, then told me I was absolutely not permitted to ride my bicycle or do any other kind of exercise until this has been sorted out.

In short, he just scared the absolute crap out of me. I have to go do the stress echocardiogram tomorrow at 3:30 pm, and I'm totally unable to concentrate on my work or do anything productive right now.

Wish me luck.

- Warren

 

[Leah]

I wish you luck! I once had bronchitis and went to a clinic since I don't have health insurance. The doctor ordered a breathing treatment, so I did that, and my heart beat became faster. She gave my an EKG and told me I had an enlarged heart! She was going to give me something to calm my heart down and call an ambulance, but I opted to call my husband to take me to the emergency room. $1200.00 later only to find out I was fine. Boy, was I mad. There was nothing wrong with my heart. I hope nothing is wrong with yours, and remember docs do make mistakes! Get a second opinion, if you ask me! Hang in there...

 

[Math Is Hard]

Aw, chroot, man that sucks! You've probably just been exercising too hard. Geez! You're about the most health conscious person I know, and I can't imagine you having a problem with your ticker. But I am glad you're getting all checked out and I'm glad you'll get your results soon! Maybe the GF can bring some movies over? You need some distraction tonight.

p.s. A few years ago, a doc told me I had a heart murmur and I got a little freaked out -- but no doctor has ever heard it in me since!

 

[berkeman]

Hang in there, chroot. And try to relax and let technology do it's job in checking you out. If there's something wrong, they can fix it, and you'll be able to get back to your normal intensity soon. Let us know what they find.

 

[chroot]

Yeah.. honestly.. I'm fulling expecting the results to come back tomorrow and indicate that I'm totally fine, and the doc was just being overly cautious. On the other hand, I have felt pretty lousy after workouts, have experienced odd bouts of syncope, and have felt palpitations. So, I'm thinking it's a good idea to get this sort of test done just as prophylaxis.

I have a 600-mile bike ride to do in June, so... I'm trying to just view this as an "in-depth physical."

- Warren

 

[illwerral]

I really don't know you at all since I'm pretty new here, but good luck with that. I hope they fix the problem, I know heart difficulties can be very non-fun.

 

[Moonbear]

Chroot, sorry to hear that. However, keep in mind they didn't call an ambulance for you right away, so while there might be a problem, you're probably not going to drop dead before your appointment. The stress test will help narrow down the problem. It might be something very easily treatable with just some medication.

I have to admit that I really hate it when a doctor just suddenly ships someone off for a referral without sitting down and discussing it with them...why the referral, why the hurry, what do they suspect, and what else could it be? I think those 4 questions should be answered, otherwise, it only seems to add to the stress by leaving someone sitting around worried that it could be the worst.

 

[-Job-]

It sucks having to wait for results on things like this. I once came close to losing sight in my right eye, and waiting for the results on that was not pleasant, it's really impossible to get any work done.

 

[ZapperZ]

All the best, chroot!

I had a ECG about a year ago because my physician thought I may have a heart murmur. He flat out told me that he is being cautious and that he does not think it serious because he said that what he heard was common. He just wanted to make sure it isn't really a heart murmur or something more serious.

It wasn't! :)

So here's hoping yours isn't either.

Zz.

Edit: one of the benefits in working at a US Nat'l lab is that they make you take a physical with their doctors every year. So I have an EKG done every other year and the doctor compares the result every time with the baseline "healty" results. So I go through TWO physicals a year, counting the one I do every year with my personal physician.

 

[chroot]

I have to admit that I really hate it when a doctor just suddenly ships someone off for a referral without sitting down and discussing it with them...why the referral, why the hurry, what do they suspect, and what else could it be? I think those 4 questions should be answered, otherwise, it only seems to add to the stress by leaving someone sitting around worried that it could be the worst.

Well, he's a family physician. I doubt he really knows the heart all that well, but he did an ECG and found something that reminded him of a previous case he had treated (successfully). The condition he suspects actually carries a small chance of sudden-onset cardiac arrest, so I think he did the right thing by referring me immediately. It's entirely possible (perhaps quite probable) that his suspicions aren't even remotely correct, but it's ethically (and legally!) the right thing to do.

- Warren

 

[Moonbear]

Well, he's a family physician. I doubt he really knows the heart all that well, but he did an ECG and found something that reminded him of a previous case he had treated (successfully). The condition he suspects actually carries a small chance of sudden-onset cardiac arrest, so I think he did the right thing by referring me immediately. It's entirely possible (perhaps quite probable) that his suspicions aren't even remotely correct, but it's ethically (and legally!) the right thing to do.

- Warren

That actually sounds more reassuring. 1) If it is what he suspects, you know he has treated it successfully before, and 2) if it isn't what he suspects, it's just being overly cautious, and no reason to worry.

I only have two classes left with my group of med students this year, so just because of this, next week, I'm going to remember to bring this up as a social issue. It'll fit in with the case we're covering a bit (someone with a spinal cord injury who would have every reason to be scared to death upon admittance to the E.D.), so I have one more chance to do my part to be sure 8 more future M.D.s are reminded of how scary it is to not know what is going on when referred for tests, or to not have their condition discussed fully.

 

[Gale]

so I have one more chance to do my part to be sure 8 more future M.D.s are reminded of how scary it is to not know what is going on when referred for tests, or to not have their condition discussed fully.

hehe, so i must be sadistic, cause first thing i thought of was you with 8 students, pulling them aside individually and tell them that you're worried about their performance in class and that you want to test them to take a learning abilities test. tell them its best not to mention it to their classmates just in case there's a problem, and ask to see them to come in for the test ASAP. they come to see you, and you have them write an essay or something on their "condition" without saying what it is, and a second question about "how do you feel about discussing your 'condition" then they write all sorts of stuff about being weirded out by some condition they never knew they had.

then you take the papers and read them aloud to the class anonymously. dicuss how it sucks to go in for tests when you're clueless what they're about or what they expect from you. fun

 

[Astronuc]

Warren - hang in there, and seriously, try not worry.

I've been having some problems exercising recently. For the last six months or so, lifting weights (10-12 sets of 4 or 5 basic exercises with moderate weights) has often resulted in my heart rate staying at 160 bpm for half an hour, plus the added fun of cold, clammy hands, dizziness, and even ringing in my ears that persists long after I get back to my desk.

The last part (after cold) is a concern. The heart should stay at 160 bpm for so long. It might be time to cut back on the exercise and take it easy.

It's good that you will be seen by a cardiologist.

It sounds a bit like over-training, which is possible, with some cardiac hypertrophy. That's treatable, part of which may be slow down and reduce the amount of exercise.

Take it easy. :zzz: OK, not that easy.

 

[franznietzsche]

hehe, so i must be sadistic, cause first thing i thought of was you with 8 students, pulling them aside individually and tell them that you're worried about their performance in class and that you want to test them to take a learning abilities test. tell them its best not to mention it to their classmates just in case there's a problem, and ask to see them to come in for the test ASAP. they come to see you, and you have them write an essay or something on their "condition" without saying what it is, and a second question about "how do you feel about discussing your 'condition" then they write all sorts of stuff about being weirded out by some condition they never knew they had.

then you take the papers and read them aloud to the class anonymously. dicuss how it sucks to go in for tests when you're clueless what they're about or what they expect from you. fun

I would hope that doesn't work with med students. I'd be a bit concerned if they didn't catch on.

That's definitely unnerving Chroot, I hope everything ends up ok.

 

[chroot]

Warren - hang in there, and seriously, try not worry.
The last part (after cold) is a concern. The heart should stay at 160 bpm for so long. It might be time to cut back on the exercise and take it easy.

I can easily keep my heart singing at 160 for hours on my bike. The number itself is not the concern; it's the fact that it sometimes continues for many many minutes after I've stopped exercising. Most people's heart rates return to baseline within about 5 minutes after exercise.

It sounds a bit like over-training, which is possible, with some cardiac hypertrophy. That's treatable, part of which may be slow down and reduce the amount of exercise.

I don't think it's overtraining. I hit the rock climbing gym for four hours a week in the not-so-distant past, and lifted weights on other days. Now, I can't even do 10 sets of easy weights without feeling like I'm going to pass out.

Thanks for the well-wishes. I shall let you all know tomorrow.

- Warren

 

[hypatia]

Sending all good thoughts your way, and wishing for the best. Of course you'll let us know ASAP what they find.

 

[Evo]

Why don't doctors just say "I want to check for x, Y & Z and give you some idea of what they're thinking. I think a patient would worry much less than if they're thinking they're going to die.

Let us know, I hope it turns out to be nothing.

 

[Moonbear]

I can easily keep my heart singing at 160 for hours on my bike. The number itself is not the concern; it's the fact that it sometimes continues for many many minutes after I've stopped exercising. Most people's heart rates return to baseline within about 5 minutes after exercise.



I don't think it's overtraining. I hit the rock climbing gym for four hours a week in the not-so-distant past, and lifted weights on other days. Now, I can't even do 10 sets of easy weights without feeling like I'm going to pass out.

Thanks for the well-wishes. I shall let you all know tomorrow.

- Warren

Years ago, back when I was still in college, I experienced something similar, but also my heart would just start racing while I was at complete rest, and then I passed out...IN a doctor's office. That got me the complete physical, visits to the cardiologist, EKG, and cardiac ultrasounds, among other things (talk about scary...I was only 20!). The final diagnosis was hyperthyroidism, which also affects the cardiovascular system. So, a bit of time on beta blockers to control the cardiac symptoms while simultaneously working on treating the hyperthyroidism (which, against all odds, resolved itself with medication alone...that was a relief...surgery was otherwise in my future), and everything was brought back under control again. It took me a few years to get everything completely under control, but I've been totally medication free for a long time now. So, even some very scary symptoms can be the result of something fairly easily treated once it gets diagnosed.

Gale, have you ever seen the movie The Doctor? That's somewhat like what they do to the med students at the end of that. I'm not enough of a sadist to do that to my students...besides, I like the group I have. Other than one who I'd like to smack upside the head some days and want to suggest he go into anesthesiology so he's only dealing with unconscious patients, the rest I have every confidence will make great doctors in a few years.

 

[scott1]

I wish you luck! I once had bronchitis and went to a clinic

I have it once every year around this time(in fact I have it right now) for past around 5ish years.I heard there is only 7 starnds of it so I only have 2 more to go until I can't get any more...

 

[heartless]

Hey,
It's sad to hear you're not doing well. It's sad to hear when anybody is not doing well. It all indeed will be fine. Have you been stressed or worried for the last couple of weeks? I think you may have a partial bundle block.

 

[Ivan Seeking]

Chroot, if all checks out and if you haven't done so, you might want to check your blood sugar. I have very similar symptoms when my blood sugar is really low, but it only became obvious when I started passing out. And even then, the diagnosis took a top notch specialist. There are variations of diabetes that are not well understood. I have one of them.

Good luck.

 

[moose]

Good luck. Thinking that there is something wrong with yourself health wise is one of the worst feelings...

 

[Mk]

I wish you luck! Hang in there...

Forget the luck! Give Doc lots of money and ask for a lot of drugs to fix you up.

 

[wolram]

Very best wishes from england, i am sure every thing will be tickety boo.

 

[zoobyshoe]

I went to a cardiologist a couple years ago and they now have a sonogram that can take real time moving images of your heart at work, imaging individual valves and chambers as they want. The state of the art for diagnosis of heart problems is excellent.

Hopefully, though, this is just some temporary hormonal glitch or deficiency in some vitamin or mineral you forgot to account for.

 

[Astronuc]

I can easily keep my heart singing at 160 for hours on my bike. The number itself is not the concern; it's the fact that it sometimes continues for many many minutes after I've stopped exercising. Most people's heart rates return to baseline within about 5 minutes after exercise.

Exactly. I wouldn't be too concerned with 160 bpm 'while' exercising - mine does the same (but up to 130 bpm) - but it's the fact that your heart stays at 160 bpm more than 5 minutes after you stop exercising.

Hopefully the cardiologist will identify the problem.

It could also be an endocrine issue (e.g. thyroid or adrenal medulla) - excess catecholamines - e.g. excess epinephrine. I believe beta-blockers are the treatment then.

Or there could be issues with the SA or AV nodes.
http://www.guidant.com/condition/heart/heart_electrical.shtml

Best wishes for a swift resolution and good health!

 

[Chi Meson]

Oh god. Can't ride the bike? One of my greatest fears is being told that I can't run anymore. Here's hoping it's something benign. Too much Gatorade?

 

[Astronuc]

Well!?

Now I'm worried!

 

[hypatia]

hmm waiting, waiting...i hate waiting...

 

[FredGarvin]

Chroot, my wife has been an exercise physiologist for cardiac patients for over ten years. I will gladly run anything by her if you want another opinion on anything. She has seen it all.

 

[Tsu]

Yeah!111 WELL...?

Are you still alive, chroot? Did you fall off of your treadmill?

 

[chroot]

Hey guys,

Thanks so much for all the kind words and good thoughts! Apparently they helped, since the stress echocardiogram came back totally clean. The cardiologist said he wished most of his patients were as healthy as me.

However, he also scheduled me to have about 8,000 blood tests run, and I'm hopeful something will show up. Today wasn't a very fun day. I had to fast for twelve hours, then show up at the hospital for the blood tests at 10 am. I was already a little shaky when I got there. After the girl had drawn no more than one vial of blood, I promptly got tunnel vision, ringing in my ears, and passed out. It took about a half an hour for the episode to clear enough to allow a doctor to draw the rest of my samples, while I was laying down.

The fun didn't stop there, of course. Even though they gave me two glasses of orange juice and a banana after the samples were taken, I nearly passed out again while driving the ten minutes to work, and almost caused a major accident.

When I got to work, I immediately hit up the cafeteria, and tried to eat a reasonable lunch. Unfortunately, I discovered that eating was agonizing. I had to force myself to just to chew and swallow a sandwich that I normally love eating. I only ate about a quarter of it, and just couldn't tolerate any more.

Then came the splitting headache. A while later, my boss came by to find me lying on the floor of my cubicle. After he roused me and I sat up again, I had to run to the bathroom and throw up my lunch in... a urinal. (Sorry, Mr. Janitor. I really didn't mean to.)

So, I left work, managed to drive myself home somehow, and slept most of the afternoon. The headache is still with me, but I'm feeling a lot better now after a decent dinner.

I really *hope* the blood tests reveal something wrong, because, you know, fasting for 12 hours and having some blood drawn really shouldn't cause me to pass out three times over four hours.

I'm glad my heart's okay, though. I think blood sugar problems are far easier to treat than heart troubles.

Thanks again for all your thoughts... I'll keep you updated.

- Warren

 

[Gale]

wow warren, i hope things get better. sounds like an awful day. hope tomorrow is better! and hope the tests turn something up

 

[Gokul43201]

Hey guys,

Thanks so much for all the kind words and good thoughts! Apparently they helped, since the stress echocardiogram came back totally clean.
- Warren

Good to hear.

 

[Moonbear]

Wow...glad it's nothing with your heart, and although it really sucks to be passing out like that, I'm glad it happened while you were at the doctor's office so they could get the blood work while you were experiencing whatever it is that's causing the problems. That really does sound like a blood sugar problem. The symptoms are classic hypoglycemic symptoms, but then it becomes a matter of determining why you're experiencing these symptoms.

http://diabetes.niddk.nih.gov/dm/pubs/hypoglycemia/index.htm

Is it possible that by increasing your training for that thing you have planned this summer, you've been burning even more calories than usual and are not eating enough to compensate?

In the meantime, unless the doctor has recommended otherwise, I'd suggest you keep a stockpile of fruits and grains (bread, rice, granola bars) around and eat lots of small snacks during the day (but none with high sugar in them...your body may overreact to simple sugars and make the problem worse).

And, please, be careful driving until things are sorted out. If you're prone to passing out lately, you might be better off carpooling with someone else to work, taking public trasnportation, or since your boss already found you passed out on the floor, he would likely understand if you took some sick days off or could arrange to work from home.