husband had + stress test, lengthy trip planned, what to do?

[acuore]

I’m a very occasional poster, but a looong time lurker (back to the Nest days!). I know there are some doctors on here, or maybe someone who has personal experience with situation we are currently in. My husband (62, generally in good health, normal weight, exercises/run regularly, eats pretty healthily, but does control blood pressure and cholesterol with medication) went to our GP a couple of weeks ago because he had a persistent cough from a really nasty cold (negative for covid, but who knows) back in January. He was mostly coughing in the morning, and when doing vigorous exercise. Running was also bringing on mild wheezing and occasional vomiting (i think more from the violence of the coughing than anything else). Otherwise, he was feeling ok in terms of appetite, energy, etc. 

Dr gave him a Flovent inhaler and also suggested a course of prevacid, as he has had acid reflux issues inthe past. Out of an abundance of caution, she also referred him for a chest x-ray (clear), a resting echocardiogram (normal) and a stress test ecg. This last test came back with “ST depression suggestive of ischemia.” (During the test itself, he felt fine, no discomfort, was able to go for 11 or 12 minutes, get to maximum HR, METs 11.) He’s never had any chest pain to speak of. 

The GP is referring him to a cardiologist for further testing (and I guess to answer any questions we have about the test results), but seems to think that this is a very reliable indicator of heart disease. I have been consulting Dr Google, but can’t get a good sense of if it’s possible this is a false positive, how serious it is if actually correct, etc. 

Aside from the regular anxiety caused by scary terms like “ischemia” and “heart disease,” i am anxious because I am supposed to be leaving for 3 weeks abroad on the 24th. We haven’t scheduled with the cardiologist yet, and i doubt we’ll get in before I go. Is there a possibility that they’ll do further testing and then decide he needs some immediate intervention? Am i safe to leave town for an extended period now? (The dr did say he can continue to exercise while waiting for the follow up with the cardiologist, so i guess they dont’t think it’s too dangerous?) 

ETA the Flovent and/or omeprazole seem to have fixed the coughing and exercise issues 

[smock]

Not a medical doctor, but I've recently had a parent with heart-related issues. In my experience, if doctors are worried about heart stuff, they send you straight to the ER.

It's possible that the cardiologist will run tests that require intervention. But for now, it sounds like the GP doesn't think it's a dangerous situation since they said your husband can exercise and he has no chest pain. I can see why you're worried about going abroad, but you're probably fine to leave town.

[mofongo]

I agree, if they were really concerned they would have sent him to the ER, a follow-up wouldn’t be enough. I think you’re ok to go as well. Sorry for the scary stress:(

[SusanBAnthony]

My H had a bad "routine no big deal" heart test, and didn't leave the hospital until he had bypass surgery. Similar to your h where he was in good health, ran 5 miles daily, and then had a "no big deal" thing checked out. I can't remember now what the test was as it has been almost a decade!

But long story short, if they were really concerned he would be either in with a cardiologist like next day, or not leaving the hospital.

[acuore]

Apr 12, 2023 18:55:23 GMT -5 SusanBAnthony said:

My H had a bad "routine no big deal" heart test, and didn't leave the hospital until he had bypass surgery. Similar to your h where he was in good health, ran 5 miles daily, and then had a "no big deal" thing checked out. I can't remember now what the test was as it has been almost a decade!

But long story short, if they were really concerned he would be either in with a cardiologist like next day, or not leaving the hospital.

Yikes, what a scary time that must have been! I hope he’s feeling great a decade on. 

[SusanBAnthony]

Apr 12, 2023 19:09:26 GMT -5 acuore said:

Apr 12, 2023 18:55:23 GMT -5 SusanBAnthony said:

My H had a bad "routine no big deal" heart test, and didn't leave the hospital until he had bypass surgery. Similar to your h where he was in good health, ran 5 miles daily, and then had a "no big deal" thing checked out. I can't remember now what the test was as it has been almost a decade!

But long story short, if they were really concerned he would be either in with a cardiologist like next day, or not leaving the hospital.

Yikes, what a scary time that must have been! I hope he’s feeling great a decade on. 

Yes he is! He was in a university teaching/research hospital for the testing and then surgery and he was the talk of the interns and residents. About 100 of them paraded through! But no issues since the bypass, just lots of monitoring since it was silent and only caught because of routine testing.

[lostrn]

Anecdote time...my dad needed a cardiac catheterization due to very mild symptoms, during which they decided they couldn't fix his clogged arteries with the cardiac catheterization and that he actually needed bypass surgery. It took them almost 3 months to actually get him scheduled and the surgery completed. My gut as a family member and with some nursing background says if it was serious they would have sent him to the ER or called the cardiologist to get him in for a consult ASAP. I think you are ok to go on your trip for now.

[acuore]

Apr 12, 2023 19:54:54 GMT -5 SusanBAnthony said:

Apr 12, 2023 19:09:26 GMT -5 acuore said:

Yikes, what a scary time that must have been! I hope he’s feeling great a decade on. 

Yes he is! He was in a university teaching/research hospital for the testing and then surgery and he was the talk of the interns and residents. About 100 of them paraded through! But no issues since the bypass, just lots of monitoring since it was silent and only caught because of routine testing.

Wow, how lucky (not the need for the bypass, obviously, but catching it before it caused any big problem). I’m trying to tell myself that, if my husband does have a condition the requires treatment, at least it was caught now, rather than just silently smoldering until hitting a critical point and becoming symptomatic. 

[acuore]

Apr 12, 2023 20:28:43 GMT -5 lostrn said:

Anecdote time...my dad needed a cardiac catheterization due to very mild symptoms, during which they decided they couldn't fix his clogged arteries with the cardiac catheterization and that he actually needed bypass surgery. It took them almost 3 months to actually get him scheduled and the surgery completed. My gut as a family member and with some nursing background says if it was serious they would have sent him to the ER or called the cardiologist to get him in for a consult ASAP. I think you are ok to go on your trip for now.

Good to know that these situations aren’t all critically urgent. Unless something big changes in the next few days, I will plan to do the trip, and do my best to keep my anxiety at bay The irony is that the trip is with my 82-year old dad, who has been having heart and vascular  issues himself over the last couple of years, so I was prepared to be concerned about that … not what was going on back home! 

[chickadee77]

Interesting. I have similar symptoms and recently saw a cardiologist due to an "abnormal" EKG at my GP's office. I've had the same symptoms for YEARS and no one ever referred me to cardio (over several doctors/states).

We also just left the country for an extended time (remote, medical services 60+ minutes away) so I was glad the treadmill test didn't show anything weird, though I have an echo scheduled for my return. The cardiologist wasn't worried at.all when she learned I have zero family history, don't drink caffeine, and had no issues with chest pain, etc. (though I do occasionally have anxiety attacks that mimic heart issues).

I hope all is well for him, and wanted to give a "happy" anecdote.

[stemmie]

Anything cardiac freaks me out. I recall the first time DH "failed" an EKG. His PCP said he'd be referring DH to cardiology Friday afternoon and the cardiologist called him Saturday morning at 8am to schedule a consult and testing Monday at 8am.

If this was urgent, he'd have been admitted. Now that this is on the radar, they may want to do further testing and maybe medicate him more aggressively.

I hope you get some reassuring answers soon.

[acuore]

Apr 12, 2023 22:55:44 GMT -5 chickadee77 said:

Interesting. I have similar symptoms and recently saw a cardiologist due to an "abnormal" EKG at my GP's office. I've had the same symptoms for YEARS and no one ever referred me to cardio (over several doctors/states).

We also just left the country for an extended time (remote, medical services 60+ minutes away) so I was glad the treadmill test didn't show anything weird, though I have an echo scheduled for my return. The cardiologist wasn't worried at.all when she learned I have zero family history, don't drink caffeine, and had no issues with chest pain, etc. (though I do occasionally have anxiety attacks that mimic heart issues).

I hope all is well for him, and wanted to give a "happy" anecdote.

Thanks! I’m glad the cardiologist wasn’t concerned. That’s always the bet outcome when seeing any doctor! 

[acuore]

Apr 13, 2023 7:22:44 GMT -5 stemmie said:

Anything cardiac freaks me out. I recall the first time DH "failed" an EKG. His PCP said he'd be referring DH to cardiology Friday afternoon and the cardiologist called him Saturday morning at 8am to schedule a consult and testing Monday at 8am.

If this was urgent, he'd have been admitted. Now that this is on the radar, they may want to do further testing and maybe medicate him more aggressively.

I hope you get some reassuring answers soon.

Thanks, that is somewhat reassuring. The stress test was April 4, and the cardiologist waited until our GP was back from vacation to relay the results to us. They also haven’t yet called to schedule, so I guess they aren’t overly alarmed. GP does seem to think medication is the most likely outcome, after additional testing. I guess we’ll see. In the meantime, as I was googling all this stuff yesterday, he went for a 6 mile run. You can tell who the worrier in the family is