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Aneurysm and Stress Tests

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  • Aneurysm and Stress Tests

    I told my cardiologist that I'm having frequent chest pain and he said that I could have a Treadmill Stress Test done. I asked about the chemical stress test where you don't have to get your heart rate and BP high, but he scoffed at that idea. This guy has me all figured out I guess. So I have it scheduled for tomorrow, but I have reservations because of my aneurysm.

    What do you guys think about having a "small" aneurysm and basically pushing it to the maximum on a treadmill?
    In the living room.

    [I]"If something is going to affect your life, it's best to know as much as you can about it."[/I] -Donald Trump

    [B][U]I am not a doctor or a medical professional! Always check with your doctor before acting on any information that doesn't come from your doctor.[/U][/B]

    [color=red]If you have/had an aneurysm, please answer my poll [URL="http://www.valvereplacement.org/forums/showthread.php?37612-Aortic-Aneurysm-and-Respiratory-Issues"]here[/URL]:[/color]

  • #2
    Increased stress on the weakened wall of an aneurysmal aorta due to elevated blood pressure is a potential cause of aortic dissection.

    I am not aware of any statistics being reported re. dissection related to stress tests but am aware that it has occurred.

    No one can guarantee that the increased pressure on the wall of the aorta will not cause it to tear immediately or set it up for a future emergency.

    Another example is heavy lifting. I know of individuals that had lifted something heavy in the days prior to their aortic dissection, presumably putting stress on the aortic wall - they did not know they had a BAV/anuerysm.

    In 2001, my husband had a chemical stress test to evaluate his coronary arteries. In 2006, the 64 slice CT Angio had come on the scene and was used prior to his surgery. In both cases, his coronary arteries were clear, which is typical for those with BAV.

    When there is chest pain and an aneurysm is known to exist, regardless of size, it should be taken seriously and handled gently. Strict blood pressure control comes into play in evaluating the symptoms, and an aortic specialist would carefully assess whether the aorta is unstable and may require intervention. If an aorta is symptomatic, it is agreed that it should be dealt with regardless of size.

    All of this is documented in the medical literature. It is important to find someone who understands this to care for those with bavd.

    Best wishes,
    Arlyss
    My husband is the patient
    AVR for BAV, critical stenosis with heavy calcification, April 1990
    Ascending aortic aneurysm, complete resection under Total Circulatory Arrest, May 2001
    Stroke due to valvular strands, November 2005
    AVR - mechanical valve replaced with tissue, February 2006

    Comment


    • #3
      Hi Aaron.....I hope you do well with your stress test...

      Originally posted by AaronJ View Post
      I told my cardiologist that I'm having frequent chest pain and he said that I could have a Treadmill Stress Test done. I asked about the chemical stress test where you don't have to get your heart rate and BP high, but he scoffed at that idea. This guy has me all figured out I guess. So I have it scheduled for tomorrow, but I have reservations because of my aneurysm.

      What do you guys think about having a "small" aneurysm and basically pushing it to the maximum on a treadmill?
      I have had a couple of stress tests done....one physical and the other chemical, and let me tell you....the chemical one in my case was horrible...I would rather do another physical one before I would do another chemical. I would trust that the doctors who are doing the test would stop you immediately if they thought for one second that you were in trouble. Here's wishing you nothing but the best for your test tomorrow. Harrybaby:D:D
      ----------------------------



      Harold L.

      I may not be able to kneel, but I can certainly bow my head in prayer that God will see me through as I know he will......:D:D



      [IMG]http://img.photobucket.com/albums/v484/Harrybaby666/License%20Plates/MontanaPlate.jpg[/IMG]

      Comment


      • #4
        I had a chemical test done a long time ago, the worst that happened for me was just burning/flushing in my face.

        Do you or did you have an aneurysm Harry?

        Thanks for the info and personal experiences Arlyss. I'm not sure if I'm going to do it. You bring up very good points. I'm very "on the fence". I bet the chest pain is from my valve or aorta anyway. It seems kinda stupid to get this done for me.
        In the living room.

        [I]"If something is going to affect your life, it's best to know as much as you can about it."[/I] -Donald Trump

        [B][U]I am not a doctor or a medical professional! Always check with your doctor before acting on any information that doesn't come from your doctor.[/U][/B]

        [color=red]If you have/had an aneurysm, please answer my poll [URL="http://www.valvereplacement.org/forums/showthread.php?37612-Aortic-Aneurysm-and-Respiratory-Issues"]here[/URL]:[/color]

        Comment


        • #5
          You may want to ask your Surgeon for his opinion on having a Stress Test. Hopefully he will have a better appreciation for the Risks to a "Dilated Aorta".

          My personal reaction is that I would want a Compelling Reason to go through with the Stress Test given your condition.

          'AL Capshaw'

          Comment


          • #6
            Not that has been diagnosed.....

            No, I haven't had an aneurysm, although my aortic root has dialated to 3.9 and has since returned to 3.3 as of my last echo....I had a positive stress test which indicates that I do have a blockage in one of my arteries, but mainly they did the stress test to try and figure out why I have had and still do have alot of chest pain. So far they have said that some of it could be caused by my Pulmonary Hypertension.. I go for another echo on June 10th, so hopefully, this echo might help get to the bottom of things. When I had my chemical test, it felt like my chest was going to explode...the pressure, the SOB, the anxiety....and the pain was horrible. Harry:D:eek::eek::D
            ----------------------------



            Harold L.

            I may not be able to kneel, but I can certainly bow my head in prayer that God will see me through as I know he will......:D:D



            [IMG]http://img.photobucket.com/albums/v484/Harrybaby666/License%20Plates/MontanaPlate.jpg[/IMG]

            Comment


            • #7
              Here is a link to an interesting paper re. aortic dissection and aortic size.


              http://www.circ.ahajournals.org/cgi/...ll/116/10/1120

              Best wishes,
              Arlyss
              My husband is the patient
              AVR for BAV, critical stenosis with heavy calcification, April 1990
              Ascending aortic aneurysm, complete resection under Total Circulatory Arrest, May 2001
              Stroke due to valvular strands, November 2005
              AVR - mechanical valve replaced with tissue, February 2006

              Comment


              • #8
                This post was quite a coincidence for me to read as just yesterday, I had a stress test and hated it. I don't have aneurysm, I have MVR and AVR, AFib and PH. I left the hospital incredibly angry.

                After 5 minutes I felt awful - SOB, heart racing, my BP and pulse rate were going nuts, and I said 'I think I'll need to stop soon' and the junior doctor who was there was totally dismissive and actually laughed. She said words to the effect that I should be able to do much longer and then increased the speed and incline.

                After 7 minutes I told her if she didn't stop it, I would fall off the thing. I had nasty crushing pain in my chest that was going up into my throat. They've always ignored me or been totally dismissive of my chest and back pain. My bp was up to 220/140-ish, my pulse was in triple figures. After it stopped, it took ages - as usual after exertion - for it all to calm down.

                It angers me that these people who have never had this illness, can be so complacent and smug when they are busy patronising us and 'assuring' us nothing bad will happen.

                I think it's analogous to saying to someone who's had a broken leg 'let's just put your leg in this vice and continue to tighten it for a while to just see how strong the bone is.'

                The trouble with medical professionals is that they understand the mechanics of our diseases but they've - rarely- had anything like it themselves, so they don't have a clue how scary it is to purposely induce things that we find are distressing symptoms of impending doom. They don't know what it's like to live in fear of 'setting off' something that will lead us to hospital - again!

                Good luck Aaron and don't forget that you do have the right to refuse to do it if you don't want to. I certainly will if I'm told to do one again.

                Lynn
                Due to have mitral and aortic valve replacement but don't know when.
                Paroxysmal atrial fibrillation
                Pulmonary hypertension still hanging on but improved.

                Comment


                • #9
                  Originally posted by lynnconnolly View Post
                  ..................... the junior doctor who was there was totally dismissive and actually laughed. She said words to the effect that I should be able to do much longer and then increased the speed and incline.

                  ......................

                  Lynn

                  junior doctor there lies the nub of the matter IMHO.

                  In my experience recently qualified cocksure young juniors are a potential liability. As docs age they become humbler and more patient friendly.



                  Re stress tests, they need stress to be effective. An unfortunate connundrum for some cardiac patients.
                  There are three ways to get something done. Either do it yourself, pay somebody to do it or ban your kids from doing it.

                  Comment


                  • #10
                    Originally posted by Bonzo Dog View Post
                    junior doctor there lies the nub of the matter IMHO.

                    In my experience recently qualified cocksure young juniors are a potential liability. As docs age they become humbler and more patient friendly.



                    Re stress tests, they need stress to be effective. An unfortunate connundrum for some cardiac patients.
                    Hi Simon, yes I'm sure you're right on both counts. I know in most of my posts that I tend to be very cynical and bitter about the medical profession, but sadly, that's been my experience. And as Aaron said, some doctors 'scoff' at things we say or ask. I hate it. I really, really hate it when they won't take it seriously when told we have pain or any other thing for that matter. It seems to be the case for Aaron, if I'm reading the post right, that they aren't listening to him. I know it's the case for many of us.

                    I have to say, THE only doctor that I trust right now to truly have MY best interests at heart is my GP, Dr Collins. I simply do not trust any other medical professional at the moment - or at least, not those with whom I'm having regular contact anyway.

                    However, I don't want to hijack Aaron's post so I'll stop ranting on now :D
                    Due to have mitral and aortic valve replacement but don't know when.
                    Paroxysmal atrial fibrillation
                    Pulmonary hypertension still hanging on but improved.

                    Comment


                    • #11
                      Originally posted by AaronJ View Post
                      I told my cardiologist that I'm having frequent chest pain and he said that I could have a Treadmill Stress Test done. I asked about the chemical stress test where you don't have to get your heart rate and BP high, but he scoffed at that idea. This guy has me all figured out I guess. So I have it scheduled for tomorrow, but I have reservations because of my aneurysm.

                      What do you guys think about having a "small" aneurysm and basically pushing it to the maximum on a treadmill?

                      I had 3 different stress tests when my ascending aorta was 4.5cm in size - prior to my AVR + ascending aorta re-inforcement in December.

                      The object was to test how high my BP rose during peak exercise, so we could assess the risks, given the dilated aorta.

                      I completed 18 minutes on two of the occasions, before I was asked to stop.
                      If you want to try and quantify risk of something happening, then it is fair to say it is extremely low.

                      My feeling was that it was better to find out what my BP was doing during stressful situations.... and what safer place to do it than the hospital?
                      [B][FONT="Arial Black"]?Life is mostly froth and bubble, Two things stand like stone, Kindness in another's trouble, Courage in your own?[/FONT][/B]

                      Comment


                      • #12
                        Originally posted by Arlyss View Post
                        Here is a link to an interesting paper re. aortic dissection and aortic size.


                        http://www.circ.ahajournals.org/cgi/...ll/116/10/1120

                        Best wishes,
                        Arlyss
                        That is VERY interesting. Makes me feel like I need the surgery done like now. Coincidentally it quotes Dr. Svensson who i'd like to be my surgeon.

                        Even with more aggressive guidelines (<5 cm), preemptive aneurysm surgery would fail to prevent 40% of acute aortic dissections seen in our registry.
                        The worst part about aneurysms is the fact that you absoutely can not know when it will happen, or if it will. One guy can make it to 8 cm, the next won't make it to 5.
                        In the living room.

                        [I]"If something is going to affect your life, it's best to know as much as you can about it."[/I] -Donald Trump

                        [B][U]I am not a doctor or a medical professional! Always check with your doctor before acting on any information that doesn't come from your doctor.[/U][/B]

                        [color=red]If you have/had an aneurysm, please answer my poll [URL="http://www.valvereplacement.org/forums/showthread.php?37612-Aortic-Aneurysm-and-Respiratory-Issues"]here[/URL]:[/color]

                        Comment


                        • #13
                          My vote is tell him to go jump in a lake. Ask him exactly what he's looking for subjecting you to stress? It better be a damn good reason otherwise, tell him to go fishing.

                          Comment


                          • #14
                            Stress tests may have their place, but in my humble opinion some medical people are too quick to use them for people with elevated risks.

                            To my amazement, just a few months out of OHS (Bentall's), I was told I would have to take a stress test to establish a baseline to get into cardiac rehab. I said hell no, I won't go (to the stress test) -- and I got into cardiac rehab anyway, and did well in it.
                            Medtronics Freestyle Aortic Root Heart Valve (Porcine)
                            02/16/05 Inova Fairfax, Virginia (Dr. Speir)
                            www.steadfastdawgwalker.com (senior fitness blog)

                            Comment


                            • #15
                              I had two during the period my aneurysm was smaller. But I wasn't smart enough to know what I know now by being a part of this enlightened forum and never questioned the test. I trusted the judgement of my cardiologist. In many ways, I just didn't want to hear any more bad news, I guess.

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