Medication Induced Cardiac Stress Tests

[smcd23]

Medication induced cardiac stress test - anyone ever have one?

My husband has to have a stress test as part of his transplant workup to be relisted, and when the local hospital called they said it was going to be medication induced, which made us all very nervous. Neither one of us thought it sounded very safe or fun. The last one he had was on a treadmill, and he has been practicing for a treadmill test and even saying how we need to get him some new shoes this weekend. I called the transplant center and asked if they could change it and I think they said they will because he's young and can handle walking or pedaling on a bike. But if they can't change it or didn't get it changed, I'd like to hear from anyone about their experience with the medication induced version.

The test is Tuesday, so I need to do some research soon I guess just in case.

[jbeany]

It certainly feels a bit weird.  They hook up an IV, lay you out on the plastic semi-padded countertop that they use for a bed, and pump in meds that make your heart race.  You get all sweaty, and can feel your heart pounding.  Then they ram the ultrasound wand into your ribs just like normal.... 

If nothing else, it's faster than the treadmill version.

[smcd23]

Interesting. The lady at the hospital said that we had to be there to check in at 9:45, the test was at 10:30 and he couldn't eat anything for 2 hours prior to the test, and that the test itself took a few hours. I figured it was because they gave you the medication slowly and then had to back you off of it. I just started reading up on it, and he doesn't meet any of the normal things that would make them have to do the test that way (can't get to an adequate level on the treadmill, poorly controlled HBP or a certain heart blockage). I know he is really nervous about it, maybe I should double check with the hospital or tx coordinator just to make sure there are no surprises...

I guess maybe they wanted to do it that way because he didn't get the desired heart rate on his last treadmill test not because he was having issues with his heart or cardiovascular system but because he was still on PD, not meeting clearances so he was still fairly uremic, and got tuckered out and uncomfortable walking while carrying his 1500ml dwell for almost an hour. When he did it before he went on PD, he had no issues. Now that he's back on hemo, he definitely has more energy and can do a lot more. During the summer he was walking with me after dinner and keeping up with my pace no problem. We go to the mall now once a week at least to just walk around because it's cold out, and he still can keep up no problem and not become exhausted. As I said, he's been practicing.

Thanks for sharing your experience though, makes me at least know what we can expect should they still go that route...

[amanda100wilson]

I had one done and it was no big issue.  put it like this, i can't remember much about it,  I seem to be forever having one test or another and they pretty much all meld together after a while.  the fact that I can't remember it tells me that no problems having it done.  much better than having to use the treadmill.

[lola]

It's the only kind Otto has now, he say's it's way easier.....

[justme15]

I did the medication induced stress test.  I was really nervous about it as well, but it really wasn't bad at all!! they inject the medication and within a  few seconds you start to get very mildly short of breath. that lasts for another few seconds and then it's over. it really wasn't bad at all! no need to be worried.

[geoffcamp]

I did the treadmill for years. But it was taking way too long to get my heart rate up (I'm a runner) so they told me about this option and I put it off. But last year I didn't have the treadmill option!!!  They even took the treadmill out of the room I'm usually tested!  I've been on the list 11 years so I know the building. So I hade the chemical one done and it was no big deal. Feels a bit weird, heart races while you lay on a bed. It is much faster and seemed to be ok. If your really not comfortable ask for the treadmill option, maybe they have it!!  Good luck and best wishes. G.

[noahvale]

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[BobN]

Agree with what the others have said.  They make you fast because the test can cause some mild nausea.

I've had a couple of these and got through with no problem.

[MooseMom]

Is Tony having an echocardiogram as well, or just a stress test?  Most tx centers require both. 

[frankswife]

Frank had his a few weeks back. It seems like I waited less time for him for the nuclear one than the treadmill one. All he said was it made him a little short of breath. Tell hubby not to worry.

[jeannea]

I found it annoying but not impossible. It's faster if you schedule the chemical one. I was scheduled for treadmill and couldn't do it. The I had to wait for them to get the medicine then I had to wait for the doctor to be free. For me the worst part is always the same: trying to get an IV working.

[ChrisEtc]

It's funny I had to take a stress test for my work up.  I expected it to be a regular stress test so I show up with my tennis shoes and shorts ready to get working.  Of course, there's no treadmill in the room so I'm like uh... okay.  I think they call it an adenosine stress test.  The only thing I remember about is that I got a terrible freaking headache from it.  It was a little weird, you feel your heart racing while you're just laying there. 

[Annig83]

I had one last May. It's uncomfortable... I say that because I have Generalized Anxiety Disorder, so it feels like a panic attack, or anxiety attack.  I had it because of transplant work-up and I had just had ankle surgery a few months previously, so no running for me! It's over realitively quick. More of a nusiance than anything else.

[Speedy1wrc]

I'll take the opposing view. Mine was horrible.

As said they give you a med to make your heart race. They also had an emergency tech standing by with the antidote in case something went terribly wrong. Statistically it's pretty nasty stuff.

The key is if you have any kidney function. If so it will pass and you'll eliminate it rather quickly. If you have no kidney function it doesn't pass. I was still having trouble breathing later that night and the clinic was closed. I called the ER and they had no idea what I was talking about with regards to an antidote. I suffered.

Could they have mis-dosed me, possibly?

For me at least it was if you are happy and rosy then 10 seconds later you feel like you just ran a double marathon and you can't breath. You see those guys crossing the finish line and keeling over? That was me. I seriously thought I was going to die.

Call the clinic and get information before you decide.

[smcd23]

Well, when the scheduler told me it was a medication induced one, I asked why it wasn't a treadmill and they said they did the medication one for all kidney patients. I said well, he's a 28 year old kidney patient, who has been practicing, and prefers the treadmill. (Legit he was out on ice skates today with me and our son because our son wants to learn to skate and play hockey. Tony was zipping around the rink while I clung to the milk crates with our son and had no issues whatsoever. Was so beautiful yet heartbreaking to watch knowing he can't play hockey himself anymore, but I digress...) The scheduler also said the order they got was for the medication one and if I wanted it changed, I'd have to call the tx center. I had to call the tx center anyway because they were trying to get the tissue typing and cross matching that was done in 2008 from the other hospital with my kidney, and I wanted to make sure they got my records, so I figured it was a good time to call and follow up on that and mention the stress test issue. Our coordinator is a peach and I love her to pieces, and she said that she could see where the hospital here had sent something back to them saying "wife states patient wants treadmill test" and the coordinator said she would have it changed for him.

MooseMom - they are not doing an echocardiogram at this time. I think so long as the stress test and his EKG's are okay, they won't go farther. I know they have recently noted a S4 gallop heart sound on his last visit so I think that is what prompted the stress test. When I looked it up, the S4 gallop can be caused by a few things, including longstanding hypertension and he also had high phosphorus for some time, which could cause some stiffening. I assume if his stress test doesn't go well (last time he puttered out of energy due to his PD fill) they will require more testing.

I will pass everyones experiences on to him, both good and bad, just in case he ends up with the medication one. Someone mentioned another nurse standing by with the antidote - that is what I pictured when they told me, and I think anything that raises the heart rate like that artificially is dangerous, especially if an antidote is needed to be waiting nearby. He also doesn't urinate anymore, so he'd be stuck with any side effects until his treatment the next day, and I don't need to deal with a grumpasaurus rex anymore than I already do!

[noahvale]

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[smcd23]

They called me yesterday to confirm, and once again stated it was the medication induced one. I stated that it was supposed to be changed to a treadmill test, and the girl checked with the doctor and called me back and said it was going to be a treadmill one. I was still nervous that it wouldn't be, so I went with him anyway, and thankfully it was a treadmill test!

They could see on the ultrasound of his heart before he started the abnormality - his muscle has thickened and hardened in one area of the heart, creating what they call a S4 gallop. He reached his target heart rate on the treadmill no problem and his BP was actually lower when he left than it was when he got there. The cardiologist said that the flow in his heart, despite the thickened and hardened muscle was still normal, so as long as he keeps his BP under control and keeps his phosphorus in the good range, there should be no more further damage. The damage that is there popped up in the last 2 years, but during that time his phosphorus and BP had gotten out of control for extended periods of time.

Hoping the tx center will get the info from the test and get him reactivated for a cadaver (despite his 99 PRA) and praying even more that a living donor will come forward.

[Speedy1wrc]

I'm glad he was able to do the test on the treadmill. I had expected that for myself but didn't find out it was the medicine induced type till I got there. I was hoping for the treadmill since I am in decent shape and the last time I did it, I passed with flying colors. In any event I also passed the medicine test too. It's done and over so all is good I guess.

Good luck!

[smcd23]

I was hoping for the treadmill since I am in decent shape and the last time I did it, I passed with flying colors. In any event I also passed the medicine test too.

He isn't even in decent shape! He didn't pass the last one he did 2 years ago, but they also didn't have him hold his beta blocker prior, so he ran out of steam before he hit the target rate. This time he hit his target rate after a little running, and was good. His only complaint was his legs burned because he never runs