chemical stress vs treadmill stress test

[Abbygirl2]

Can someone please end the mystery. I have one cardiologist who says the chemical stress is given in place of the treadmill stress test in certain circumstances. However my 'new' cardiologist said that they are 2 different things and that I need a treadmill stress test. I am all for it, but am confused as to whether they are similar or not.

Pam

[Sarah]

Well, the second doctor may think that the first doctor is talking about a stress echo and not a stress treadmill.

The chemical stress test is used to put a strain on the heart without making someone run or bike if they can't handle it like older people or someone with other disabilities or if their HCM is such that they couldn't get to the target level.

The treadmill is just you, hooked up to equipment, running to reach a target rate and they see what your heart and bp do under exercise. No chemicals.

I had one doctor want to do both on me, but since I get migraines and the stress chemical can give you a headache, they skipped it. I have had three or four treadmill tests over the years.

Personally, the equpment is so annoying that I never do as well as I might do on my own.

I suggest having the doctors duke it out themselves, see why the one is so keen on chemical over treadmill --is he concerned about your ability to handle a treadmill, for example?

take care,

S

[Burton Borrok]

Back in 1985 I had a stress treadmill test and was pushed beyond my limits. I went flying off the back of the treadmill while the doctor was on the phone with his back turned. Took about five minutes to gather enough strength to get off the floor and onto the examination table with the help of both the doctor and the nurse. Took another fifteen to twenty minutes for things to quiet down enough for me to walk shaky legged out of the office.

Ever since, I’ve had chemical stress tests, and they all were a snap, except for the last one in March, when they used a different chemical, and I thought I was having a heart attack. They injected another chemical and within a minute I was back to normal - except for a monster headache. Had a mess of chemical stress tests and expect I’ll have a bunch more, - but I don’t like them anymore.
Burt

[Laoshur]

Pam,

Like many here, I too have had both. I am no expert, but my take on it is that it probably depends on what they are trying to see that determines whether they are the same or different. In my case the reason for the chemical test was to watch the heart continuously during stress. I don't know if this helps, but I guess I would ask the docs why they want to do either type of test and maybe it will become clear why one doc says they are the same and the other says they are different.

Rhoda

[Abbygirl2]

Thanks all, I am thinking that the reason they gave me the chemical stress echo was because I was pregnant but I can't imagine them giving that stuff to a preg. woman. Yeesh!!. I'll have to check my records. If I were not pregnant than there would have been no reason(that I can see) why they would not have given me the treadmill stress test. I know my first Dr(that gave me the chem. stress) said he wanted to watch my heart under stress. So perhaps they show different things, because I know this new Dr wants to give me the treadmill stress test to see if my BP reacts normal to excercise, I guess maybe that doesn't show on a chem. stress test. Ah, well I go back to the new guy in 2 weeks or so, I guess I will find out then. Thanks

Pam

[Glen Beamish]

Pam, some people can have a reaction to the chemical. I did and my blood pressure went sky high.
They just stopped injecting it and my blood pressure went back down after a few minutes.
The test was to see how my blood pressure would react under stress, go up or down. Since it went up, that was what they wanted to see so it worked out OK.
They don't want to see your blood pressure go down while being stressed.

[Abbygirl2]

Glen, thanks for the info, they gave me Amyl Nitrate, they broke a little package open and waved it under my nose. It was horrible, my head felt like it was going to explode..ugh.
He said everything went good so I am assuming that whatever he saw was 'normal'. My husband confirmed they gave it to me twice while I was pregnant (and once afterwards) -- My memory is sooo bad.

I wonder if different chemicals do different things. Ah well, I want the stress test(treadmill) done anyway, so I guess it really doesn't matter.

Have a great day all.
Pam

[Glen Beamish]

Pam, the Amyl is different than the chemical they give you for the stress test.
I get the Amyl every time I get an echo, gives you a rush and then gives
me a headache.
The chemical, and I forget the name of it, they give to you intervenus over a period of time while you lay hooked up to various equipment..

[Burton Borrok]

You know,
When I got out of the army and was finally home again I went to a neighborhood bar and took a chemical stress test. I got so stressed in fact, that when I got home I had to hang on to my bed to keep from flying off. And oh, the next morning did I have a headache – man. It was so much fun I never self administered another chemical stress test again.

It rivaled the time I was at a family party in my uncle’s finished basement. I must have been around 10. I snuck behind the bar and started sampling all the different drinks. I developed a raging fever, and later that night I slipped into a semi-coma. I came out of it days later and then had what was called ‘Intestinal flu’. I wasn’t able to go to school for two weeks. Scared **** out of everybody.
Burt

[Laoshur]

Glen, the chemical I got was dobutamine. I Googled "chemical stress echo" several months ago and was surprised to see that there are several different chemicals that are referred to that way. I am also curious as to whether there are differences between the use of these.

Rhoda

[Abbygirl2]

ok, I am figuring this out. So Amyl nitrate is NOT given for a chemical stress test. Then I have never had one, which makes me a little steamed to say the least! What the heck is the point of the Amyl Nit. then? Anyone know?

Pam

[Burton Borrok]

Pam,
Did a little research and, after I cut out all the references to its misuse, this is the kernel I found.

“First produced in 1857 as a treatment for angina, amyl nitrate evaporates at room temperature. The vapor released causes your veins and arteries to dilate resulting in the blood flowing faster through the heart and the brain.”

Amyl nitrate can be found in some doctor’s and dentist’s exam rooms taped to the wall or a cabinet door. It is usually in small crushable vials inside a gauze wrapper. To release the Amyl nitrate you crush the vial still in the wrapper between your fingers and wave it under the nose of the person who has, or is about to, feint - to revive them. I believe the police still carry it in their squad cars and emergency vehicles carry it also. A good whiff of it feels like somebody is blowing the back of your head off. Hope this is of some help.
Burt

[Glen Beamish]

Pam, they can give you the Amyl while there doing the stress test just to give you the rush you get, but it is not the chemical they inject for the rest of the test.
Like Rhoda says there appears to be several different ones they can administer.

[Laoshur]

Pam,

I checked online to see what I could find about the action of amyl nitrate and found this site: http://www2.umdnj.edu/~shindler/amyl.html. It contains abstracts for many articles dealing with the use of this compound including several on patients with HCM. Apparently one purpose is to attempt to induce a gradient in a patient who is not obviously obstructed. This is either the same as or very similar to what happens in a chemical stress test, so yes, I think you probably did have a stress test. Another purpose is to see if a heart murmur is lessened with the administration of amyl nitrate. It appears that this lessening of murmur can be used to help eliminate other heart murmur causes and strengthen the diagnosis of HCM.

Hope this helps!
Rhoda

[Glen Beamish]

An attempt to induce gradient is exactly why they use it on me when I'm having my echo.
Thankfully it has not happened.

[Abbygirl2]

Thanks all, you guys are champions. I guess they were trying to induce my gradient, which they did. It rose from 16(resting) upto 36. I don't know if thats good or bad, but atleast now I know what the Amyl was for. I wonder if they were able to see what my blood pressure did as well.

Burt thanks for finding that info for me!! Much Appreciated.

Rhoda, thanks a heap, I will check out that website right now.

I luv you guys!!
:D
Pam