Stress Test

on Thursday, June 24, 2010 at 7:05 AM

Went for a cardiac stress test yesterday.  I also had an echocardiogram done while there.  I have to wait 2 weeks for the official report.  I tried to garner some information from the people doing the tests, but all they said was that everything looked okay. Not sure if that's what the tell everyone so as to not scare you.

My family doctor suggested the stress test after I mentioned the weird symptom that I sometimes see while running.  Here's an example from when I ran a marathon last fall. 

I started the race out fine, but at about the 2mile mark, the HR spiked for 4 miles and then returned to normal. It doesn't happen on every run and I'm not sure if there's anything that triggers it. It's a weird symptom.  I can sometimes sense when it starts since it feels like a skipped heart beat, but other than that I don't really know that it's happening unless I look down at my watch.  As far as I can tell, it impacts my performance only during shorter faster races where VO2Max becomes a limiting factor.  I think that's why I have problems with 5k races.  The harder intensity means that the HR is more likely to spike which causes a worse performance when it does. Anyhow the main objective of a stress test is to stress the heart to try and get it to do something abnormal and then analyse what the abnormal part is.

I had my echocardiogram done first.  This is where they use an ultrasound to take various pictures to get an idea of what the heart looks like and the blood flow through it.  The tech said that everything looked fine, but I'm not sure if she was the one doing the analysing or if a doctor is supposed to look at the pictures and issue a final report.

Then had the fitness test done.  They hook you up to a bunch of electrodes to get an EKG and then put you through a treadmill test at every increasing intensity while monitoring your blood pressure. The doctor asked some general questions about my HR issues and wanted to know a bit about my running. I said that I ran marathons and she then mentioned that she was a runner too and was doing her first marathon this fall in NY.  She then said that we might be here a while since the test builds up only gradually and most people will bail at some point during the test once the effort level increases.

So the test starts at a slow walking pace and flat incline.  Every couple of minutes the pace and incline of the treadmill increases and they measure your blood pressure.  I kinda figured early on that my HR was not going to spike during this test since from experience I know that if i build up the effort gradually enough, the HR will not spike and since this test was doing just that, it probably wouldn't reproduce the conditions that cause it to occur. I think I got a lot farther into the test then most people would because the treadmill started to make some strange noises at the higher speeds and the tech and doctor began to comment on it like it was a weird occurrence. The HR never did spike and the test shut down after what I'm assuming is the maximum effort level that the treadmill can induce. It could also have been that they thought i was working too hard since by the end of the test, i was dripping lots of sweat.  I'm not sure of the speed but by the end, it felt like around 8min/mile.  The incline was somewhat steep though.  My legs were starting to fatigue at the end and I was breathing somewhat hard, but not like interval hard. Afterward, they said my HR peaked at around 180 which for me is a good tempo effort when I know from past experience my max is at around 190.  In total, I think the test lasted a max of 15 minutes.

I'm somewhat disappointed by the test since I don't think the test really "stressed" me. But I can understand the reasoning for the treadmill test.  Most people that come in for stress testing have heart issues and are not involved in exercise and are usually of older age. Most of the people in the waiting room were seniors and the people who were younger seemed to be people who had brought their parents/grandparents to the office.  The test should induce cardiac stress in most people, but just not me on this particular test. 

I have to wait for the official results, but assuming that they don't report anything wrong, I will have to examine some other options as I'm still concerned about the increase in HR.  Another option which I'll have  to talk to my doctor about is a Holter test which is where you are hooked up to a portable EKG unit that you wear for 1 to 2 days.  I was actually hoping that my doctor would initially prescribe this instead of the treadmill stress test .  I think the main purpose of having the stress test done in a doctor's office is that you would have medical personal there in case anything bad happens.  The downside is that you are somewhat limited by the artificial test conditions present whereas if I used a holter device, I'm fairly certain that I could get my HR to spike under conditions of my choosing. 

Anyhow, I'll report on the results when they come in which should be in about 2 weeks.