Neccesary Testing Decision

[hefner33]

Hi

I need to make a decision on getting a heart CT. The suggestion to my Dr came from me because I asked about checking blockages but the most non invasive way.

I am a 32 male, non smoker, 6'6" 235lbs. History of collegiate sports, with 2-3 times a week jogs of 3 miles.
Diet is decent.

Over the past year I have had what I have thought are cardiac events. Near syncope a couple times and then blacking out after a run around Christmas. I also had a period where any exertion was shooting my heart rate to the 130's - 150's just walking up stairs with palps. And just standing my HR would sit around 110 which isnt normal for me. Had a recorded BP's around 200/90 on several occasions. No one ever knew what came of that. I currently have a LINQ loop recorder implanted in me. The only thing they have seen in this is my HR gets in the mid 30's at sleep and can get all the way up to 180 when running. Blood pressure avgs. 115-125/60-70. At once I was told that I had low blood pressure and to eat salt. Then was told i could possible have dystonia but tilt test didn't show any severity.

My last visit I expressed concern about palpitations during my runs (frequent pacs and pvcs). Somedays I would have them and other days I wouldn't at all. But I would still have pacs/pvcs during the runs (feeling them or not) cause I can track them using a HR monitor and a HRV app. There have been several times where I start to feel wobbly when running. So not sure if its from becoming panicky or from something different. My recovery hr usually is about 35-40 beats the 1st min if its not too hot out. I use to usually use this as a indicator but not sure about it. My most recent stress echo was back in summer 2014. I copied and pasted below. But I dont take to much trust in those.

To my point I asked to check for blockages and wanted non invasive. They recommended the Fast Motion Heart CT Scan. However I don't even want to do this just cause Im trying to get away from radiation as I have had multiple radiation scans over the past 2 years. Several CT scans and multiple xrays. Also add the cost of the procedure itself. The cardio said is was viable option and wasn't against but I don't know if I am just asking for something thats unnecessary at this time.

I have some family history in distant relatives but their events occurred after 60 two were defects (hole in hearts) that were never found and Ive had to full echos.

Age: 31 years Sex: Male DOB: 07-Apr-1983
Author: Austin (Fellow MD), Christopher O
Test Interpretation
Impressions: Negative for chest pain, Negative stress ECG for ischemia, adequate heart rate recovery,
126 %FAC (functional aerobic capacity) (31 year old, male), Duke treadmill score 15.0 Risk low.
Procedure
Cardiac Stress Test
Test performed: motorized treadmill Bruce protocol, Total time (14 minutes, 59 seconds), Total
METS achieved 17.2.
The test was terminated due to: general fatigue moderate.
Reported level of perceived exertion: 17.
Chest pain: The patient did not experience chest pain.
Baseline heart rate 77.
Peak heart rate 171.
Baseline blood pressure 134/78.
Peak blood pressure 160/60.
90 % PMHR (predicted maximal heart rate).
Double product achieved 27,360.
Post-exercise blood pressure 170/72.
Baseline ECG description: normal sinus rhythm.
Stress ECG findings: No ischemic changes.
Additional Stress ECG findings: ventricular premature contractions rare, atrial premature
contractions frequent (Moderately frequent single APC's in early exercise; occasional aberrant
conduction noted. Frequency diminished at higher heart rates; one VPC noted.).
Test monitor: Johnson RN, Adelle S .

[hefner33]

Yea. I actually have a opposite effect toward caffeine or energy drinks. My HR stays pretty stable or lowers and my BP doesn't really change at all. I assume I have a tolerance from using caffeine often in earlier years.

[ed34]

It's just that many contain a dosage of caffeine which has the same effect as snorting several lines of cocaine up your nose. One young man recently died in the uk after frothing at the mouth and his heart rate was over 200.

[hefner33]

On occasion yes and sometimes starbucks lattes. What do you mean over react?

[ed34]

Ok your heart rate isn't dangerous but I have to ask if you consume energy drinks? Some people seriously over react to these and even die.