Does an abnormal stress test suggest a health issue?

Question

Hi doctor,

Shortness of breath and rapidly reaching my maximum heart rate have been concerns for many years. I turned 50 this year, and it is impacting my ability to exercise, so I thought it was time to investigate. I just had a cardiac catheterization test, and no blockages were discovered. However, they were unable to complete the procedure through my wrist because my right artery does not connect directly to the heart; instead, it connects to the left artery, which then goes to the heart or aortic arch.

The stress test results showed abnormalities at high heart rates, both in the EKG and the echo. Are there any health issues related to this abnormal artery connection? Besides being out of shape, are there any other medical issues I should consider or investigate? I am currently taking Amlodipine and Losartan regularly for high blood pressure.

Please advise.

Answer 1

Hi,

Welcome to icliniq.com.

First, you need to start on medications called diuretics, such as Torsemide 10 mg once a day in the morning. Additionally, Amlodipine should be replaced with beta-blockers, like Metoprolol 25 mg once a day. Both medications will help relieve your symptoms and provide other benefits. Please discuss this with your local doctor. The symptoms you are experiencing are due to pulmonary congestion, which is influenced by both hypertension and your anomaly.

The next important decision will be whether to pursue surgery to correct the abnormal connection. I need to know the details of your reports to understand the exact type of anomaly and the course of the artery. You can upload your angiography report for review. Since this is a rare condition, the decision is not straightforward, and the data is inconclusive regarding the preferred treatment modalities. In some cases, patients are offered surgical management, while in others, they are managed with medications. The decision also depends on the physician’s opinion and the patient's willingness to undergo such major surgery. I believe you should be started on the medications I mentioned above and then monitor your response.

I hope this helps you.

Thank you.