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Cardiac tests


calypso
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I am wondering what kinds of heart tests everyone had done to determine if you have a normal structured heart. I have had an echo, Holter, event monitor and EKG, but I have not had stress tests and am wondering if this would be a good idea, since I do have some shortness of breath that never seems to go away and borderline high BP. My cardio says I don't need more testing, but I am not so sure.

Any input is appreciated!

Amy

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I have had all of those tests plus a stress test. If you feel uncomfortable with your doc's recommendation then I would discuss it with him or get another opinion. With the shortness of breath, have you ever been checked for asthma? There are also a lot of other things that can cause shortness of breath like smoking, being overweight, allergies, asthma, etc? I would definetely check into getting a second opinion if you are uncomfortable and your doc is unwilling to change his stance on the additional testing. Good luck!

Jaime

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I've worn a 24-hour holter monitor and had an ekg and a stress-echocardiogram. (A stress echo, by the way, allows them to do a baseline echocardiogram and then they do a stress test right after, where you walk on a treadmill and they monitor your hr and bp etc for a set amount of minutes. They stopped mine after about 9 minutes, not because I was too tired but because they "didn't want to see what would happen if I went over 200 bpm." (Would I have exploded? I'm still curious!) Then you lay back down and they do another echo, watching the heart go back to resting.

It's my understanding that the echo provides the information needed to rule out mitral valve prolapse as well as other structural/mechanical problems. You don't need a stress test for that ... I don't think I'd pursue one if I'd already had an echo and other cardiac tests AND been diagnosed with POTS.

Amy, you do wear 30-40 compression hose (or thigh-highs), don't you? If not, give 'em a whirl; I find they help with all my symptoms, including shortness of breath!

m

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I've had everything, holter, ekgs, stress test(walking and induced :) ) and I've had the angioplasty, not to pleasant for me as I have a mild allergie to iodine, I was on huge doses of benedril, etc. The wanted to be sure my irregular heart rhythem was my brain, not my heart. If you have chronic shortness of breath, I would follow up on that, not your heart.

good luck Blackwolf

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i've had a 3 echocardiograms, 1 holter monitor, all the usual cardiac blood work and of course the ubiquitious ecg/ekg's (had so many of those i'd probably make a pretty good tech myself. heh)

justin

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Amy,

Over the past 3 years (since diagnosis) I've had an EKG, 24 hour holter, 30 day event monitor, multiple echocardiograms, stress test, bloodwork, you name it...however, the shortness of breath is a fairly common everyday symptom of POTS.

It was explained to me like this- as we know, the blood pools in our lower extremities, causing a lack of blood to the heart, lungs, and brain. When the lungs sense a low level of oxygen, our brain is signaled to take a deep breath to restore the balance. So chances are, when your other symptoms act up, you may ave shortness of breath as well, especially if pooling and lightheadedness are a common occurence for you. Merrill's suggestion to wear compression stockings is a good one, since they help push blood upwards. Are you taking any medications? Pro-Amatine would be beneficial if you can tolerate it. Yoga positions that open up the chest used to be helpful for me when I first got sick and breathing was difficult.

Good luck!!

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If you feel that you still need a stress test, ask your doctor if it will show anything your previous tests might not show.

That said, look for another cause of shortness of breath. Here are few other causes:

Asthma This one can be helped by a correct diagnosis followed by treatment. A person with POTS and asthma must be careful not to take asthma meds that affect heart rhythm. There are some contradictions when having both asthma and POTS

For example, some asthma treatments aim to make you more dialated while to treat POTS you want to be constricted. Beta blockers can contribute to the development of asthma in allergic people. If you do find out you have asthma, it can be handled while living with POTS. Your meds must be chosen with knowledge and care. There is also a form of asthma called exercise induced asthma.

Stress I have reacted to stress by getting short of breath. Not sure how this works, but it does happen. Shortness of breath can also be caused by anxiety. Shortness of breath can be part of an anxiety attack.

Chest wall pain Sometimes chest wall pain can make you feel like you are short of breath when you really are not. In this case, the pain can be minimal and have the effect of feeling like can't take a full breath or exhale correctly.

There are many other causes of shortness of breath as well.

Here are a couple of tests you might want to ask about:

Pulminary function test You take in the biggest breath you can and exhale into a machine that measures your exhalation lung capacity.

Pulse Oxygen Test You put your finger in a sensor that measures the amount of oxygen in your blood. My doc once wondered if my oxygen drops with exercise so he took a pulse/ox reading then had me walk briskly around the parking lot at his office for ten minutes and then did another pulse/ox test.

My PCP who is a family doctor was able to do the pulminary function and pulse/oxygen tests in his office. An allergist can do them in office, too.

While the above 2 tests must be done in a Dr. office, there is a device for patients with asthma to check their breathing called a peak flow meter. You take a deep breath and exhale into it and it gives a numerical reading. This one you have to know how to use and intrepret. I got mine from my allergist. In order to use it correctly, a person must know what their "normal" reading is. Then you can tell if you are low. I only mention this because I have one. And whenever I feel short of breath, I use it. Interestingly enough, most of the time I feel short of breath, I will score as normal. For me that usually means that I am precieving myself to be short of breath when I am really feeling stress, anxiety, or low level chest wall pain.

Keep us posted.

Michigan Jan

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Wow, thanks for all of the info, everyone! MichiganJan, I have had an abnormal pulmonary function test, but the fact that my shortness of breath came on just three days after having my daughter, and the fact that my POTS symptoms all started at that time too, makes me think it's POTS or heart related. There are many big cardiovascular changes in the body in the immediate postpartum period. I am just wondering what kind of changes could have occurred that would be giving me so many odd symptoms beyond POTS -- like the excessive muscle wasting and weight loss, and CONSTANT shortness of breath. If the shortness of breath was all POTS related, seems to me that when I lie down, it would go away. But rather, it improves slightly but by no means feels "normal."

Jessica, I can't do Proamitine because my BP is running too high.

I am just going to ask again for a stress echo, just to be safe. And if the doc doesn't comply, oh well, at least I tried.

Thanks again.

Amy

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everything. i've had everything you can have done including eps and ablation, but excluding angioplasty and open heart. the echo is the best and least invasive test for checking for structural problems. the stress tests are hard, simply because we tend to be so excercise intolerant. i had one doctor chart i was very deconditioned, but with my heart rate, i would never be able to get conditioned. i would not get an ablation without an opinion from someone very specialized in pots. that's what finally pushed my body over the edge and put me where i am now. on disability. they thought they were doing the best thing for me, but didn't bother to ask a doctor specializing in pots. good luck. at this point, i get an occasional holter to check on heart rate and arrythmias and every two years i have a resting echo. i feel that's all that's necessary. morgan

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amy, sorry just thoroughly read your last post. ask cardiologist for a cpet. a cardiopulmonary exercise test. the only difference is they are looking at how your lungs and heart are working and how they are working in conjunction with each other. it is not invasive and gives A LOT of info. it's just a treadmill with a breathing tube attached instead of just breathing through your mouth. the nice thing too is, a doctor is present the whole time and will not keep you on the machine if you start showing any stress. usually a pulmonologist will be there. it is a far more accurate test for the symptoms you are having. morgan

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Guest Julia59

Blackwolf---did you mean angioplasty---or and angiograhm? :) Angioplasty is an actual procedure where they widen an artery that is blocked and then add a stint.

If you had the Angioplasty---that would mean you had some sort of blockage. I'm not and expert at all by any means----but I learned medical terminology while taking a medical billing course.

Those were some of the easier medical terms-------unlike pancreatocholelithiasis---which means abnormal condition of a gall stone wedged in the pancreas via the bile duct------LOL--------------------- :P

I didn't read all the posts---so I apologise if the question was aready asked.

Take Care,

Julie

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