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Old 05-21-2007, 08:43 PM #1
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Default Anyone Had Cardiac Testing with PN?

Hi - I'm scheduled next week for a cardiac adenozine stress test and echo - I have advancing cardio-myopathy and the docs are trying to figure out if its from autonomic PN - amyloid - or something else... Since I cant walk on the treadmill - the adenozine stimulates your heart with drugs as if you are exercising and from the info sheet I was given to prepare - does not sound pleasant (before PN I had heart rythm problems and had regular stress tests on treadmil - no problem) - but I do occasionally get severe attacks of tachycardia - even on my heart meds, and I have to stop them the day before.... the last thing I want is another trip to ER cause of heart complications... the test is critical though - I need GI tests etc and the docs wil not do them until I get cardiac clerance.....

Since I know many of you have problems walking and perhaps have had this - would appreciate any feedback

Thanks

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Old 05-21-2007, 09:01 PM #2
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Default thumper

Hi,

I had a max stress with echo and a tilt table with isoproterenol....I got sick on the isoproterenol and then passed out. Adenosine is not the same thing, and I have no experience with what you are going to have done. Isoproteronol does induce a 'stress response', but I don't know if it is different than the adenosine. I have the opposite problem than tachy..I get brady. You know, every one is different, and some folks breeze thru things, others have a tougher time.


It sounds like a good idea to have the testing prior to the GI testing though. I imagine you already had a cardiac cath?? I was scared when I had this stuff done, especially the cardiac cath....I had a right and left done. But, I figured I had to trust those folks, what option was there? I am still here. The good thing about the heart is...in general, it is like working on an electrical appliance. They are pretty competent at keeping them going and pretty good at jumpstarting them if you need it. Let me know how it goes.
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Old 05-21-2007, 11:20 PM #3
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The thing about the stress test with adenosine is they are trying to get you tachycardic. I think they must be doing this in the hospital, right? because what they want to do is see how your heart responds to the extra demand of working so hard, and if things go wrong, there should be a cardiologist there who can give you something to stop it.

People dont like this at all, from what I hear. They find the powerful beating uncomfortable. But it shouldn't be painful. Some people, I think, get scared. They feel like they're having a panic attack--a racing heart and nothing to have caused it, like going up a treadmill. I think you've been through worse, but my guess is you'll find it unpleasant.

They did this to my friend who had a stroke a few weeks ago. They found his carotid artery was blocked, but they wouldn't operate without medical clearance. So the medical clearance consisted of the adenosin stress test. He failed it. SO then they had to decide whether to do a triple bypass before reaming out his carotid, to do both together, or what. In the end they put him on beta blockers and did the carotid. But I dont think he hated the test, just found it really weird feeling, like he was anxious.
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Old 05-22-2007, 04:55 AM #4
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Default Hi Karen

I have had an echo,tilt table,halter monitor, 4 or 5 EKG's and an ambulatory monitor. This has all been over the last 2 years due to my PN.
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Old 05-22-2007, 09:59 AM #5
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Default tests

The isoproteronol also gives you that pounding heart beat and that fight or flight feeling, but beyond. They informed me it would feel icky, but I would be fine. Yes, I had mine in a hospital, with a crash cart, cardiologist and several nurses nearby...and an IV in. They are prepared for any contingency, and really, I felt pretty confident they could manage it....they really watched my EKG and vital signs...they don't take it lightly. Altho I felt icky, it was over pretty fast, once they got the info they needed, that was it. Over.

Some people with autonomic neuropathy have profound cardiac changes when the GI system is stimulated, such as, getting hypotension after eating, called 'post prandial' hypotension. I do get that at times.) I take erythromycin a very small dose to stimulate my stomach to empty....but that can cause a prolonged QT syndrome in some people (arrhythmia). I can't take metoclopromide (Reglan) as it is antidopaminergic. So all I can take is the E-mycin, and I don't take it if I don't think I need it as one develops a tolerance after a while.

I don't know what GI testing you are having...but for 'gastric emptying time' you have to down some 'stew' pretty fast, and then they take pictures until it disappears into your intestine. For 'transit time' all you do is swallow a capsule and come back for an 'xray.' I didn't have any other GI tests other than colonoscopy and the aformentioned two. I know there are more tests they can do, but this was all they needed for me at the time.....I am hoping they don't scope my esophagus and stomach....but that is probably down the line somewhere. I think the nastiest part, and every one gets to do this sooner or later, is downing that drink to clean you out for a colonoscopy...it is just so darn much to get down...it doesn't taste all that bad, it is just getting it all down when you have gastroparesis! I didn't have enough room! The actual scoping isn't too bad...some people don't feel a thing!
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Old 05-22-2007, 10:27 AM #6
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Default Hi

Thanks folks, I already have the tachycardia and asked the doc several times if he would be there cause I know the treadmills I had the doc was standing there the whole time - he said the techs are trained to handle - I hope so! Without my beta-blockers he knows I already get tachy attacks (sometimes real bad and have lasted up to 45 min at over 160 bpm) and he has my cardiac history (does include an electropsyioloigcal study of my heart to look for an extra pathway which could be sending it into tachy - they couldnt find one at the time) but now they are concerned because of the heart failure (with 3 leaky valves and descreased ejection fraction) - which I did not have 2 years ago..... to get some peace of mind - I think I'll call the techs today and talk to them directly about this procedure and just how prepared they are... (the echo at least is painless)

Cyclops, I did have gastric empty five years ago and failed it - so we know I have gastroparesis - and live on the motility and nausea meds and liquids only - but the symtoms have spread to lower abdomen in the form of constant unrelenting pain and nausea - so they want to do complete endoscopy/colonoscopy (which has to be done under general anesthesia cause I cant tolerate opiates) they are going to look for "normal" abnormalities as well as do amyloid biopsies all the way thru - they just keep thinking they havent found it yet (amyloid)..... again, cardiologist wont give me clearance for anestesia until this test done....

Anyway - will call cardio today and see if I can get more info and hopefully will stop stressing - dont like it when people mess with my heart!
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Old 05-22-2007, 11:52 AM #7
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Default Okay, I have another STUPID question!!!!

Why can't they just do an angiogram, (to test for blockages, etc.)

Why do they have to do a Stress Test first?? and if you can't go on a treadmill, why do they have to put you on the table, inject you with meds to "race your heart", give you tachycardia, etc.etc.??

Can't they just do an angiogram. Wouldn't that tell them what they need to know. Alan's cardio guy told us over 18 months ago (the angiogram is the Gold Standard to test for blockages). So if it's the Gold Standard, why not just proceed to the angiogram part?

See, I just don't get this. Why put people on a treadmill and watch them lose their breath and gasp for air, and then they say: "oh now you need an angiogram"!!!!

Anybody have a clear cut answer for this???

Thanks,
Melody
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Old 05-22-2007, 12:23 PM #8
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Default Not a stupid question...

An electropsyological study actualy did run wires into my heart trying to figure out what is causing the rythm problems... and agiogram isnt indicated in my case (my arteries arent blocked) - they can see by my echos, etc. (I've had holter monitors every year since I started having problems and periodic echos) - that its my heart muscle itself where the problem is (it doesnt beat strong enough - and is getting weaker - the heart muscle is getting stiffer and therefore valves leak and I dont get enough oxygen so get very short of breath... and with 3 echos in the past 3 years - has really progressed) - they are trying to determine what is causing this - because if it cant be stopped its pretty bad news.... if the underlying cause is autonomic neruopathy or other issue - they will try to control with meds (which I already have been on one for years) and ultimately tell me heart transplant if necessary... if its amyloid - the prognosis is very poor... I have a family member who died of cardio-myopathy a year older then I am now - and was so long ago they didnt have the technology to determine cause etc.... in any case - I know I've got a good doctor.....

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Old 05-22-2007, 12:40 PM #9
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Keep us posted. I hope you get an answer soon.
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Old 05-22-2007, 01:32 PM #10
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Yes hon. Me too. I do hope they can help you.

Take care and sending you cyber hugs.

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