stress test if you're non-ambulatory?

[Nan2u]

Was talking with a friend of mine whose mother is taking a stress test. Apparently this is part of her regular yearly physical, and from what i gather, alot of senior citizens have this test anually. Anyway, it got me thinking, since the test involves walking on a treadmill, while they monitor your heart, how would someone who can't walk take a stress test? I've been sci'd for a million years now, and the treadmill-thing obviously won't work for me, and my heart rate is slightly diff than an AB because of the sci, so when the time comes for me to take a stress test, will it even be possible? Will the dr's know to take into consideration my sci heart rate?

[SCI-Nurse]

Nan2u - You have asked a most important question for a person with a SCI. You have not mentioned your level of injury however it is known that persons with quadriplegia and complete injuries are at a higher risk of coronary heart disease (CHD). It is also known that persons with SCI have a 28% higher risk of CHD than the non-disabled population. Further, as persons are living longer with SCI, CHD is a leading cause of morbidity and mortality among the SCI population.

What can you do, since you cannot participate in the traditional Exercise Stress Test (EST) using a treadmill? There is an EST known as a "pharmacologic" (drug/medicine)stress test. ie The heart can be stressed using a medication rather than the active exercise performed on a treadmill.

What is important for you as a SCI patient? In addition to your injury, it is important that your physician be aware of your family history...i.e. is there a history of CHD within your immediate family which would therefore put you at increased risk due to hereditary factors. Secondly, what is your cardiac and cardiovascular history since your injury. If your physician has not established a baseline of functional ability through physical exam, cardiovascular laboratory tests and an electrocardiogram, this would be important to establish now, even though you are many years post-injury.

You need to ask your primary doctor if he is aware of the risks for CHD within the SCI population; does he know how to evaluate a SCI person and what tests are going to be impacted/altered due to the presence of SCI. If he is not familiar with the above, it would be appropriate to ask if he would consult with a cardiologist who has SCI expertise, as to the management goals for you in relation to your long-term cardiovascular health. If he is unwilling to do this, you could ask for a referral for a consultation by someone with SCI expertise.

For more detailed information re: cardiovascular health and SCI go to: http://calder.med.miami.edu/providers/MEDICINE/scimed.html CRF