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Has anyone had a Regadenoson Stress Test?
At present, I cannot do a standard exercise stress test due to needing a TKR. To complicate matters, I am changing all of my doctors to ones in a different hospital. The first doctor who could see me was a cardiologist. He comes highly recommended and seems quite knowledgeable. I had endocarditis in 2019 where both my prosthetic aortic valve and my aortic root had to be replaced. I have total heart block, which I'm told is most likely due to the nerve between the upper and lower chambers was severed while replacing the aortic root. Due to this, I am 100% dependent on my pacemaker. Although I just had an echo at my former cardiologist's office, my new one wants to do his own and also wants me to do a stress test. Due to my knee problems, I have a lot of pain throughout my leg. Thankfully, it primarily bothers me when I lie down. On the bad side of that, it's very difficult for me to get into bed and to sleep. I was having a lot of pain on the day of my appointment so I am realizing I didn't ask the questions I should have asked, such as why does he want me to have a stress test so bad that he wants me to have a Regadenoson Stress Test? Would it be possible to have this after I meet with the orthopedic surgeon in April? I was told I'd have to lie down for the test and that they will inject chemicals into my body to cause it to imitate things that happen while exercising, so I've been trying to practice lying on my back for as long as possible, which right now is only a few seconds. I sent him an email today telling him that I'm not sure I can do it (it's scheduled for the middleo fo February) and asking if he thinks it would help to have some physical therapy or see a chiropractor to try to get things aligned there. Right now, although it doesn't hurt, my spine is popping a lot. The place that hurts most now is around my sciatic nerve in my lower back. The PT who inadvertently triggered the problem when she hit an arthritis spur while using a massager on my IT band, thinks that my knee may have been the root cause of me not being able to regain my mobility after THK in 2022. Her explanation was that since I injured my knee in a sports injury and learned to compensate for it, the hip surgery and then her disturbing the knee arthritis bought to light all of the problems. To me, it makes sense that if possible, try to get the knee and the rest of the leg to, at minimum, stop hurting and have the stress test when I can perform it without the chemicals. My cardiologist did not mention any reason for concern. My EF on the echo from my previous doctor was 35-40, which was the same as last year when I was not allowed to exercise for about 6 weeks due to a problem with the other leg. The reviewing physician said there was "mild" thickening of the heart walls and "insignificant" regurgitation in the mitral and aortic valves. What would cause a doctor to want to rush to a stress test after an echo? (BTW, I'm scheduled for a re-do echo on Feb. 11). As I read more about the Regadenoson Stress Test, I'm not comfortable with it. Has anyone had this done?
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I had a similar test done while I presented at the local ER for atrial fibrillation. The attending physician ordered adenosine to be injected into the IV while several people looked at the morphology of the ECG waveform. I was warned that it would make me feel terrible, that it was short-lived, and that a full recovery is normal.
The idea of this test is to stress the heart the same way it would be if you were to walk quickly on an inclined treadmill, or to run, or to cycle on an ergometer of some kind. What this does is show on their screens where there is 'ischemia'...if any exists. Ischemia is 'lack of oxygen supply' to local tissues. Often the heart, itself, is ischemic and that can lead to angina and to an infarction. The cause is always going to be inflammation and /or stenosis...narrowing...of the blood vessel affected, and that is due to plaque deposition. It's known as atherosclerosis.
My own experience with the adenosine injection was typical. The kindly nurse warned me that I would feel 'dread' or 'doom' as the chemical began to slow my heart. She added that it lasts a whopping ten seconds...if that long...and that the feeling will pass quickly. She was 100% on the mark. I knew what was happening as that horrible sensation began, and I just gritted it out for all of 8 seconds or so. Meanwhile, the cheerful internist said, as he pointed to the screen, 'See? There is it...flutter.' It wasn't visible previously, but the slowed and stressed heart electrical impulses were clearly visible on the ECG at that point.
This entire process, from having the ECG leads put in place, to the IV inserted, and then to the point where the internist pointed at the screen, might have been 10 minutes. Things tend to move quickly when the patient is in apparent cardiac distress. From there, I was offered an electric cardioversion where they paddle you after you are sedated, usually with propofol. If things go well, you're conscious again inside of four or five minutes and wondering what all the fuss around you is about.
Thanks for replying. Do you have a pacemaker?
No, just atrial fibrillation, but it is in abatement now almost two years because I had two catheter ablations. However, in between the two ablation procedures, my outreach nurse from the cath lab told me my Holter monitor results showed '..a LOT of PACs.' These are premature atrial complexes, or contractions, depending on who's talking.
I have had four cardioversions (I know one woman currently in Israel who has had over 50!!). None of them worked for more than 16 hours and I was back in AF. In preparation for my second ever cardioversion is when I had the adenosine experience. It wasn't repeated the next day, or the next (I was at the ER three times over three days, cardioverted each time).
Amazing.