Expert: Todd Bublitz, RCEP - 10/19/2006

Question
-------------------------------------------
The text above is a follow-up to ...

-----Question-----
I have rheumatoid arthritis plus a foot that is subluxated which makes fitness walking painful.
I have two questions for you, Todd, please.

The first is what water exercise program can help me achieve overall fitness.

Secondly...please tell me what the most accurate
tests and procedures are now to diagnose cardiac health issues.

Thank you so much!

Sincerely,  Anne B.
-----Answer-----
Anne,

Any exercise you can do will help you achieve fitness.  I don't mean to be simplistic or vague, but it is true.  ANY EXERCISE will help; swimming, water exercises or water aerobics, walking, stationary cycling, rowing, arm cycling (arm ergometer), light-weight lifting machines, etc.  The greater the variety, the more you will improve your overall fitness.

There are several tests that can diagnose "cardiac health issues", but it depends on what you are looking for.  A cardiac echo (ultrasound) can find structural problems such as valve problems.  A simple EKG can diagnose old heart attacks and electrical system abnormalities.  To look for blood flow restrictions in the heart arteries, a nuclear imaging test (thallium stress test) is probably the best.  This is a first line test.  If it is abnormal, further, more invasive,  tests can be done - like a cardiac catheterization (putting a catheter in your upper leg and running it to your heart and injecting a contrast into the arteries to find where and how large blockages are).

I hope this helps.

Todd          

Thank you very much, Todd, for your answers.  I have one followup question.  In terms of cardiac tests...I have been diagnosed with an enlarged left ventricle, or non compliant left ventricle.  I am interested in tests that can detect the early stages of heart failure.

Thank you again

Answer
Anne,

Heart failure is often first diagnosed by the patients' symptoms and physical finding (shortness of breath, weight gain, fatigue/weakness, swollen feet/ankles, dry cough).  Once heart failure is suspected, it can be confirmed by a chest x-ray, echocardiogram, or the blood test "B-type natriuretic peptide (BNP)".

I get the feeling that you are looking for a test that will tell you that are getting close to heart failure or are in the early stages of heart failure.  The best way to determine this is to watch your energy level and weight.  The early signs of heart failure are fatigue and weight gain (due to water retention).

I suggest you talk with your doctor about your concerns and learn more about your personal condition and options available to you.

Best wishes.

Todd