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Treadmill stress test and Beta blockers

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  • Treadmill stress test and Beta blockers

    On Tuesday I went to my cardiologist's office to take a treadmill stress test, which is going to be explained to me this afternoon. It's been about three weeks since my OHS, and this is the first visit with the cardiologist since the surgery.

    They wanted to get my heart rate up to 137 but I wasn't able to get it that high before I had to get off the treadmill. It occurred to me afterwords that I am taking Coreg (25 mg 2x daily) for HBP, and I am wondering if a heart rate of 137 would even have been achievable while taking a beta-blocker.

    I'm going to mention this to the cardiologist this afternoon, but can anyone tell me if I should have skipped taking the Coreg before taking such a stress test?
    [FONT="Fixedsys"]"Bionically powered since 08-08-08"[/FONT]

  • #2
    I'm surprised that they would not have asked you what meds you were taking at the time of the test....I never stop taking mine for anything because my heart will take off and end up on the next planet!
    BAV-Aortic Stenosis...AVR Oct 11, 2005 / St.Jude Regent mechanical 21mm
    INR Home testing since 2007 with Coaguchek XS...Self-Dosing

    "Caution: I may have been in contact with Nuts"

    Comment


    • #3
      Hi,

      I have posted this information many times on the site. I find it extremely valuable.

      I hope this will help you explain to your doctors how to handle this in the future.
      Below is the information..

      Rob


      Topic: Heart Disease: Laurie Anderson, RN, BSN >> Discussion: Exercise with
      low pulse from medication (by Arlyp (WebMD))
      Re: Exercise with low pulse from medication
      by ljandie91 (WebMD), 8/18/00 10:09 PM
      Hello,
      Your heart is getting an adequate workout as long as you raise it 20-30 beats
      per minute over your resting levels. You can't calculate a target heart rate
      based on the traditional method of subtacting your age from 220 and
      multiplying it by 70-85%, because of the beta-blocker.
      In the cardiac rehab setting we usually use 70-85% of the highest heart rate
      achieved on the pre-exercise stress test, if the medication(s), especially
      beta-blockers, were taken before the test. If the medication(s) were held,
      the highest heart rate achieved must be further adjusted for these meds;
      typically a range of 10-20% more depending on the size and frequency of the
      beta-blocker dose and the dose(s) of other medications being taken that may
      also be lowering the heart rate. Sometimes this method of calculation is
      ineffective; in this case we often use the simple formula of resting heart
      rate plus 20 to 30 beats per minute. This range is decided upon based on
      whether or not the person is still ischemic (blockages that are preventing
      adequate blood flow to the heart), the amount of heart muscle damage from the
      heart attack, the ejection fraction and other individual considerations.
      In regard to your question about time of day to exercise, in my opinion you
      are actually better off to exercise earlier in the day, when your
      beta-blocker is having the most efffect on your heart rate. I can't evaluate
      this in relation to your condition, because I don't know what the situation
      is with your heart's blood flow. In general the effect of the beta-blocker is
      to improve blood flow to the heart muscle, so it is better protected from the
      potential effects of decreased blood flow and thus you are less likely to
      have angina. Hope this is clear and helpful; I will watch for additional
      posts from you should you have another question.
      Sincerly, Laurie Anderson, RN, BSN
      3/23/00 Ascending Aortic Dissection-St. Judes mech valve+graft, Vanderbilt, Nashville, TN
      9/16/10 ON-X Aortic Valve/Root Replacment, Cleveland Clinic,OH, Dr Pettersson
      9/16/10 Aortic Stent and Frozen Elephant Trunk Procedure, Cleveland Clinic,OH, Dr. Roselli

      Comment


      • #4
        I've never heard of anyone skipping a beta blocker before a stress test... that would be kinda crazy, actually. It would be like inviting bad things to happen. They usually want a normal baseline with you taking the meds that, in reality, you'll probably be on for the rest of your life.


        But yeah, I second what Bina said about never, ever skipping a single dose. If I don't take my meds within a few hours of the schedule I feel it big time. I plan any dose or medication change very carefully to keep my blood pressure and heart rate under control. I'm extremely sensitive to the peaks and troughs of the plasma concentrations.
        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
          Rob,
          Thanks for your post. I hadn't read that before, it was good info.
          Deanne
          __________________________________________
          Mom of patient - 19 yr old Brian (pictured)
          Aortic dissection, 2 emergency OHS 6/30/06 & 7/1/06, heart failure, implantation of Heartmate II LVAD, triple CABG
          3/13/07 explantation of LVAD, on-x aortic valve, dacron ascending aorta, mitral valve repair, 1 new CABG

          Comment


          • #6
            Originally posted by RobThatsMe View Post
            Hi,

            I have posted this information many times on the site. I find it extremely valuable.

            I hope this will help you explain to your doctors how to handle this in the future.
            Below is the information..

            Rob
            Thank you very much. Extremely informative! No one ever actually suggested to me I skip my meds, by the way, that was just me speculating.

            I had my appointment with the cardiologist this afternoon and I asked him about this, he agreed that it was impossible for me to reach 137 bpm.

            (The good news is he said I am doing well and he cleared me for the hospital's cardiac rehab program, also to go back to work @50% for two weeks and then 100% after that. Er, maybe that last part isn't good news, now I have to starting working again )
            [FONT="Fixedsys"]"Bionically powered since 08-08-08"[/FONT]

            Comment


            • #7
              I have had 2 stress tests since my surgery in Feb '07 and both times I was told not to take my beta blocker nor drink caffeine the morning of the test. I was given a pamplet with these instructions. Not having my coffee about did me in on my last one in July. My bp was actually kind of low prior to the test and the tech was kind of concerned about giving me the test. My test feedback was good, even though I felt like I was out of gas.
              Mitral Valve Prolapse/Regurgitation
              MV Repair, Port Access, 02/21/07 by Dr William Ryan, Presby Hosp, Dallas

              Comment


              • #8
                Hi Al,

                Glad it helped.

                btw... I am on a beta blocker, Atenolol. I also exercise regularly and within my routine is a brisk 30 minute walk on the treadmill at a 4.2 mph pace. The highest my heart rate goes up to is 98! I cannot even break 100. At rest it usually is around 72, then on the treadmill it will bump up to the upper 90's range. But that's it!

                So, as I often tell my wife these days.. Just call me " Mr. Excitement"

                Rob
                3/23/00 Ascending Aortic Dissection-St. Judes mech valve+graft, Vanderbilt, Nashville, TN
                9/16/10 ON-X Aortic Valve/Root Replacment, Cleveland Clinic,OH, Dr Pettersson
                9/16/10 Aortic Stent and Frozen Elephant Trunk Procedure, Cleveland Clinic,OH, Dr. Roselli

                Comment


                • #9
                  Rob, guten morgen.
                  what is your BP? And how much Atenolol do you take?
                  BAV-Aortic Stenosis...AVR Oct 11, 2005 / St.Jude Regent mechanical 21mm
                  INR Home testing since 2007 with Coaguchek XS...Self-Dosing

                  "Caution: I may have been in contact with Nuts"

                  Comment


                  • #10
                    Hi Bina,


                    No problems with my BP. It is usually 117/64.

                    I take 50Mg of Atenolol in the morning, and now also take 50 mg in the evening. This help control me from going into a-fib/flutter, since I started having issue with that two years ago. Prior to that, I only took 50 Mg in the morning.

                    I never had any A-fib/flutter issues for the first 6 years after surgery, and never had any heart related issues prior to my dissection.

                    Rob
                    3/23/00 Ascending Aortic Dissection-St. Judes mech valve+graft, Vanderbilt, Nashville, TN
                    9/16/10 ON-X Aortic Valve/Root Replacment, Cleveland Clinic,OH, Dr Pettersson
                    9/16/10 Aortic Stent and Frozen Elephant Trunk Procedure, Cleveland Clinic,OH, Dr. Roselli

                    Comment


                    • #11
                      100 mg is a pretty significant dose man. That's what I was taking before I switched it up to 50mg in the am and 180mg of Verapamil in the pm. There was definitely noticeable improvements in alot of aspects after I switched.
                      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


                      • #12
                        Originally posted by RobThatsMe View Post
                        Hi Bina,


                        No problems with my BP. It is usually 117/64.

                        I take 50Mg of Atenolol in the morning, and now also take 50 mg in the evening. This help control me from going into a-fib/flutter, since I started having issue with that two years ago. Prior to that, I only took 50 Mg in the morning.

                        I never had any A-fib/flutter issues for the first 6 years after surgery, and never had any heart related issues prior to my dissection.

                        Rob
                        Rob, that sounds like what I need....my Metoprolol just isn't doing its job right now.
                        I wake up with an irreg HB and can barely get out of bed to take my pill.
                        Mind you, I'm having a stressful week, and my doc still hasn't called me back.
                        I'll do some research on Atenolol in the meantime.
                        vielen Dank.
                        BAV-Aortic Stenosis...AVR Oct 11, 2005 / St.Jude Regent mechanical 21mm
                        INR Home testing since 2007 with Coaguchek XS...Self-Dosing

                        "Caution: I may have been in contact with Nuts"

                        Comment


                        • #13
                          sorry to hijack thread but wanted to ask...If you are able to get your heart rate up high, is that a good thing?

                          I recently had a stress test and got it to about 170..probably could have gone a bit higher..What is the significance of getting a higher rate?

                          My feeling is the high heart rate generally reflects being out of condition more than being in good condition...as your heart has to work harder..

                          Comment


                          • #14
                            Originally posted by offwego View Post
                            sorry to hijack thread but wanted to ask...If you are able to get your heart rate up high, is that a good thing?

                            I recently had a stress test and got it to about 170..probably could have gone a bit higher..What is the significance of getting a higher rate?

                            My feeling is the high heart rate generally reflects being out of condition more than being in good condition...as your heart has to work harder..

                            Hi,

                            I think that is why they call it a "stress" test. Kinda like putting a car through its paces.

                            In some cases, specifically mine for example, It is best that my heart rate is not high. I have an asending aortic disection. The more times a heart beats the more the walls of my arteries take a beating, compound that with high blood pressure, (if you have it), and it equates to this... More pulse hits, with higher force against the walls of my circulartory system. I am sure others have similiar health issues which also require fewer beats with less pressure.

                            That is what Beta blockers help control. They are designed to provide two things, 1: Lower the heart rate, and also 2: Lower the blood pressure.

                            If you are taking a beta blocker, and you can still get your heart rate up to 170, I would strongly suggest you let your doctor know of this.

                            If you are not on a drug that is designed to lower your heart rate, then 170 may be high, but probably an OK level while working out. I think some of us that can provide the details of what would be considered the "Target" heart rate during workouts for people not on heart rate medication.

                            Hope this helps explain...

                            Rob
                            3/23/00 Ascending Aortic Dissection-St. Judes mech valve+graft, Vanderbilt, Nashville, TN
                            9/16/10 ON-X Aortic Valve/Root Replacment, Cleveland Clinic,OH, Dr Pettersson
                            9/16/10 Aortic Stent and Frozen Elephant Trunk Procedure, Cleveland Clinic,OH, Dr. Roselli

                            Comment


                            • #15
                              What about those of us who can wake up during a good sleep with a HR of +120 bpm?
                              Is that stressful to my heart?
                              BAV-Aortic Stenosis...AVR Oct 11, 2005 / St.Jude Regent mechanical 21mm
                              INR Home testing since 2007 with Coaguchek XS...Self-Dosing

                              "Caution: I may have been in contact with Nuts"

                              Comment

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