Medical test worries

[Sammie99]

I have had 9 MI in the last 12 years, I have 3 stents and was diagnosed with COPD (Moderate Emphysema and Chronic bronchitis) and Severe Sleep Apnoea 2 years ago.

I am aged 50, and transsexual so I have male internal organs.

I was asked to do the 6 minute speed walking test (walk as fast as i can for 6 minutes and stop every minute to have my pulse, heart rate and blood oxygen level recorded).

At the 2nd minute monitoring my heart rate was at 150bpm then plummeted to 55bpm for a few seconds and shot back up to 140bpm and it did this at every minute monitoring section after the 2nd one. At the end, I was so breathless I needed a while to recover, but walked out with a strong headache and weak legs I couldn't walk to the bus stop and had to get a taxi home.

My worry is that the COPD team might have been pushing me to much to a point where Heart failure was a major risk and I should have had a qualified Cardiac Nurse present and not a trainee Nurse do the test.

[Dr Masud Haq]

Thank you for your post.

The speed walking test sounds different from a standard exercise treadmill test. This involves continuous walking without periods of rest.
Based on the observations made, it does sound unusual that your heart rate dropped so quickly but understand this was only for a few seconds.

Could this have been a technical / recording problem as this was so brief?

I would be interested to know whether you have episodes of palpitations, dizziness or blackouts at rest or on exertion. This might suggest an irregular heart rhythm which would require further investigations.

The technicians that usually supervise such tests including yours are all well trained. A cardiac nurse would not normally supervise such tests however. Occasionally, these tests are sometimes supervised by a doctor or nurse but it all depends on the individual case.

Regards
Dr M Haq