Tomorrow I head to my cardiologist’s office for another in a seemingly endless series of tests. I know my life changed on Oct. 15, 2011 when I had a heart attack and that things will never be the same, but I had no idea how often I’d be subjected to diagnostic tests. I feel like the proverbial guinea pig.
Since it has been seven years since my cardiac event, I only have to see my cardiologist a couple of times a year now. But between those exams, I am required to have a blood test regularly (keeping an eye on my cholesterol, triglycerides, blood sugars and more) and then regular stress tests and echocardiograms. Tomorrow I get the double whammy — a nuclear stress test and an echocardiogram.
A nuclear stress test is a type of stress test that uses radioactive dye and an imaging machine to create pictures showing the blood flow to your heart. This is more involved than a standard stress test in which the victim (er, patient) is simply hooked up to an electrocardiogram (ECG) and blood pressure cuff to measure your heart’s reaction to exercise. For the nuclear stress test, you are also hooked up to an IV for the dye injection.
During the same visit, I’ll be subjected to an echocardiogram which is basically an ultrasound of your heart (it’s just like the ultrasound a pregnant woman receives to check on the status of her baby except instead of finding out the sex of the baby you find out the strength of your heart). The echo is a simple test, but I’ll never get used to the cold goo.
To be more precise, an echocardiogram takes images of the size and shape of your heart and also show how well your heart’s chambers and valves are working. This is pretty critical for me since at the time of my heart attack I had permanent damage to my heart muscle and it’s important to keep track of any changes in the amount of blood my heart pumps (known as ejection fraction). A normal heart’s ejection fraction is somewhere between 50 and 70 percent, while anything below 40 means you are in heart failure. At the time of my heart attack my ejection fraction was between 30-40 depending on who you believe, but with medication, exercise and time it has bounced back to around 60 at last check. For me, my ejection fraction is how I keep score of how I’m doing and so far, I feel like I’m winning.
The stress test, on the other hand, basically tries to determine if any of the coronary arteries that supply blood to and from your heart and blocked. A typical stress test is not foolproof, but a nuclear stress test is a much better way to determine if you have any blockages. Frankly, neither test is perfect and to be sure the best way to check for blockages is to insert a camera into your arteries but that’s pretty invasive and only done if the stress test or other indicators (like actually having a heart attack) suggest you might have a blockage. Basically, if I “fail” the stress test they’re going to go in and check and if I have blockages they can blast them with a balloon (angioplasty) and/or insert coronary artery stents to prop open the narrowed pathway. I had three stents inserted at the time of my heart attack, but the angiogram showed no other significant blockages so…I have that going for me.
All this is to ensure I have not gotten any worse since my heart attack, and thankfully, so far, I have not. In fact, I’ve gotten better. Still, these tests have become part of my routine and will likely continue to be part of my routine until such time as medical science comes up with a better way to see if your heart and arteries are doing what they are supposed to do.
I know these tests are helping me live longer, but I still feel like I’m at the doctor or a testing center all the time. It’s a pain in the ass. I know I should feel fortunate that I live during a time when we have all these diagnostic tests, and on top of that I have darn good medical insurance to pay for all these tests. But it’s still a pain in the ass.