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Wednesday, April 23, 2014
Stress test question
My ECG showed a "poor R wave progresssion." The doctor wants to do a stress test with the drug "dobutamine." Wouldn`t a regular stress test be safer? I have a heart murmer (systolic click) and high blood pressure (159/90.)
The purpose of a stress test is to screen for "ischemia" (that is, when the heart is working hard, it is not getting enough blood flow to it because of blockage in the coronary arteries). The key to the test is to get the heart rate up to a sufficient number (which is based on your age) - the method in which the heart rate is raised does not matter. Some people are able to achieve this heart rate by exercising on a treadmill stress test.
If there are reasons why a person could not exercise long enough on a treadmill to get their heart rate to that number (for example, they may have a bad back, arthritis in the knees, be out of shape), then using a drug, such as dobutamine, is used to raise that heart rate. The risk is the same whether the heart rate is raised by exercise or by dobutamine.
If you are sure that you could get on a treadmill and exercise long enough to get your heart rate to that level, then talk to your doctor about this.
W. Fred Miser, MD
Associate Professor of Family Medicine
Director of Ohio State Medicine Residency Program
College of Medicine
The Ohio State University