Never heard of CP-related heart disease--I think your doc is full of it (and himself). Karl, I have very mild hemi (left side) and I've been treated, successfully, for Paroxysmal Supra Ventricular Tachycardia (heart just decides to go racing at 140-190BPM with no external stimuli) for 22 years. I asked every cardiologist who would answer if they had ever seen any type of heart disease where CP is a primary factor, and none of them had. Secondary? Well, yeah, if your disability leads you to a sedentary lifestyle, but you have no problem there, obviously. 110% of standard on the Army Physical Fitness Test (APFT) for Males 62+ is a 1 Mile run under 14:51. 2X that in a walk is doing remarkably well!!!
Physical and Chemical stress tests:
I've had both and prefer the physical--if I can get my heart rate fast enough. With the meds I take, getting the HR fast enough to stress the heart is a problem. Don't take the meds, though, and the HR won't come down after the test. The physical test simply feels like your exercising while hooked up to a 12-lead, O2 Sat monitor and spirometer. If things feel funny, you simply stop.
The chemical test, I don't like. It uses drugs that either makes the heart beat faster/stronger or dialate the blood vessels. I got a cocktail of both. Some folks do fine and actually prefer the chemical test as they dread how exercise makes them feel. To me, the chem test was akin to a bad panic attack. Usually backing off on the drip causes the heart to return to normal rhythm, etc. If your heart won't slow down they will IV push something like Verapamil to slow it.
If it were me...push for another cardiologist, expert or no. You are his CUSTOMER and he works for YOU! You wouldn't accept that BS from your mechanic, why accept it from a prima-donna doctor. This was found on a routine physical, so it's unlikely that anything adverse is going to happen while you find a decent cardiologist.
My tuppence.
Kyle Cleveland
-----Original Message-----
From: Cerebral Palsy List [mailto:[log in to unmask]] On Behalf Of KARL THUNEMANN
Sent: Wednesday, January 13, 2010 8:33 PM
To: [log in to unmask]
Subject: Two matters of the heart
Hi, everyone --
Here's an issue where I am looking for information and insight on two separate questions.
During my annual physical this fall, my doctor took a routine chest x-ray, and called me a few days later to say that it showed I had an enlarged heart. He used convoluted language so he wouldn't have to use that phrase, because it could be alarming. But I knew what he meant.
He sent me to a cardiologist, a renowned expert in our region who shot through the exam room on roller skates after his nurse had conducted an EKG and interviewed me. I hardly got to complete a sentence without his interrupting to say, I've got that. I asked him if this could be related to my mild hemiplegic cerebral palsy. Yes, he said, there is a heart condition that is related to cerebral palsy, but true to form he provided no details. He probably figured there was no reason to talk to me about it unless it figured in his final diagnosis. He gave me an appointment for a stress test that was two months out, so I figured he couldn't be too alarmed.
I thought I had something specific I could look up, but the Internet was as maddening as ever in its vagueness. It seems that the older you are and the milder your symptoms are, the less likely you are to find useful information about CP.
Oh, and I got a little more info from the EKG report, slipped to me by my PT. I have a heart murmur, possibly as a result of hypertension, though it possibly is of no consequence. The report suggested that the doctor was undecided between a physical stress test and a chemical one, though in his "visit" (doing violent injustice to this noble word by ascribing it to his brief interlude with me) he left the impression that it would be physical.
So essentially, I have two questions:
1. Do any of you know anything about this CP-related heart condition, merely acknowledged in passing?
2. What are the comparative advantages and drawbacks of stress tests, physical and chemical? (I'm 65, and on a good day I can walk two miles in 40 to 50 minutes.)
Thanks so much for your help.
Karl
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