Heart & Cardiology/stress test results


I am a 39 yr old woman in good health..I have ongoing anemia, and a slight heart murmur.
About 2 weeks ago I had an episode ofsyncope, dizziness, numb left arm and palpitations.This went on for over 15 mins. so ambulance was called. i could not stand up on my own, was pale as a ghost, and developed significant nausea. The whole episode lasted a hour. The cardiac monitor in the ambulance showed an irregular heartbeat, but was never reproduced in the ER.The tech inthe ambulance suspected a fib based on the rythym strip. It took 45 mins. to get to the hospital as I was in the country.I have been very fatigued since, get short of breath super easily. I have been going to follow up test trying to see what this could be. I still get palpitations that feel like a hummingbird in my chest or something flopping around. It can happen many times in 1 day, and the nothing for a day or 2.

I had a stress test and no significant ST changes were noted, but i have a blunted response to exercise in regards to my blood pressure.baseline was 138/70.It dropped at peak exercise ton 130/70.My heart rate reproaching 170.My recovery heartrate was unchanged. There has been a lot of cardiac issues in my family, particularly the women..so i am a bit concerned.

I will be having a holter test as well, but was curious what this BP could be cause by. Should I be concerned?

Hi, the following are some links to stress testing and also afib http://blog.myheart.net/2014/03/17/do-i-need-a-stress-test/, http://blog.myheart.net/2014/06/29/afib-with-rvr-when-the-heart-races-out-of-con.

Its a shame that the rhythm strip from the ambulance was not printed out for review as that could have answered the question of whether you had an episode of afib or not. The holter test appears to be a reasonable next step, the only problem being that the symptoms have to occur while the holter monitor is on. If the holter is negative but the symptoms of palpitations continue longer term monitors, and hand held monitors that can be activated when the palpitations occur are further options.

With regards to the stress test there are a number of things we look for. The main ones are the length of time achieved (correlates with better prognosis) the ST-T segment changes (you didn't have any,  this is a good sign that there is no critical underlying disease) and attainment of peak heart rate to ensure a reliable test (its good you reached 170). In terms of the blood pressure response, i would not worry about this in your case as it hardly dropped and is likely of no real significance. If it had dropped to 90, or gone above 200, then we would be a little more concerned. Given your history, the best thing you can do, is pay close attention to management of cardiovascular risk factors such as blood pressure, cholesterol, diet, exercise, smoking etc.

Hope that was helpful.

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Mustafa Ahmed MD


Cardiology, Interventional Cardiology, Cardiac Surgery, Hypertension, Pulmonary Embolism, Structural and Valve Disease


Board Certification Internal Medicine and Cardiology Interventional and Structural Cardiology


Multiple Publications In High Quality Peer Reviewed Journals. Internationally Recognized.

MD from The Royal Victoria University of Manchester, England Medicine, Cardiology, Interventional Cardiology, Research Training - University of Alabama

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