Dobutamine stress echo tomorrow

[Tracy74]

Dr Fett,

I go for my stress echo tomorrow. I feel quite nervous as I've been having palpitaions every now and then (my cardio says they're normal eptopic beats that lots of people can have) but will it be ok having a dobutamine test done? They don't do exercsie ones at my hospital. I have been told they're very safe and controlled well. Would you mind reminding me what result I'm exactly asking for? Can they tell me the results there and then or is it something that need to be worked out (contractile reserve)? I had recovered EF of greater than 55% soon after diagnosis and it was 68 % in June this year

Many thanks,

Tracy

[JAMESFETT]

Good luck in the stress echo. You will certainly be in a very controlled situation, and your doctors will monitor in the ways needed. With an exercise stress echo we compare the resting heart rate LVEF to the target exercise heart rate LVEF. The difference represents contractile reserve. There are no established guidelines for PPCM patients in the "adequate contractile reserve" category, but we have placed "normal" as "at least 15 % gain." I don't do or work with the dobutamine stress echocardiography, so would refer you to each center that does for their norms. Again, good luck.

JD

[Tracy74]

Thanks Dr Fett. Will they know the results straight away? When I have regular echos done the technician won't tell me what the EF is. They always say the doctor has to do that so wondering if it will be the same with the stress test. If all is positive with results then I hope to consider another pregnancy. This woulsn't be until next year. Would I need another stress test done or if there is adequate contractile reserve tomorrow would things stay that way?

Many thanks,

Tracy

[JAMESFETT]

Nothing is "forever" but in general, yes, so long as the LVEF stays up there, the contractile reserve will also. The dobutamine stress echo is scored differently, and it may take more time than the simple exercise stress echo that compares LVEF at resting heart rate with LVEF at target exercise heart rate. In general, however, the information is almost immediately available, so you will need to work with your providers on that.

JD

[Tracy74]

Dr Fett

I had the dobuamine stress echo this morning. I will get more specific results when I see my consultant in a couple of weeks but the doctor today basically worked out as resting EF to be 63% ( it was 68% 3 months ago - does it matter that it's dropped a little? I asked the doctor today and he said it didn't) and the EF at target heart rate was 80% which would be (if I've worked it out correctly) about a 26% increase...is this looking good?

Thanks,

Tracy

[JAMESFETT]

That's just fine, all the way around, and very encouraging for full recovery. It does not matter so far as the resting LVEF 63 or 68. That will vary from time to time and what we are looking for is an LVEF 55 % or greater. We do not seek higher and higher numbers after that.

JD