So my nurse prac/doc had me do a big old heart stress test and did some nuclear imaging. I was so excited to get the data evaluated after some chest pains after hard rides. All she said was everything looks fine. I’m like - I spent a half day and 1k out of pocket for all these tests so am looking for someone who can really walk me through the data. I think at this point I need to look more into a doc with sports medicine background?
I hate to tell you but there is not a lot of data that would be very useful for you from this test. Most important “data” would be total exercise time, the amount of ischemia (areas of the heart not getting normal blood flow) and the ejection fraction (percentage of blood ejected from the left ventricle with each heart beat). They do report max heart rate but max HR on the treadmill does not equal max HR on the bike. Should be pretty easy to Google the expected exercise time on the Bruce protocol for your age/gender to compare it. Exercise time over 9 minutes has an excellent prognosis. Since they said it was “ok” there should be no ischemia on infarct seen on the perfusion images and the ejection fraction should be at least 55%. This implies no flow-limiting/severe coronary artery blockages and normal heart function. If your “pain” is pressure/tightness/heaviness that only occurs with heavy exertion and relieves with 5-15 minutes of rest or you have multiple risk factors for heart disease then it would very reasonable to see a cardiologist. Really don’t think Sports medicine is what you are looking for - if you think your pain is musculoskeletal, spending money on a bike fit might be wiser. Disclaimer that none of the above shoukd be taken as medical advice as I am not aware of the specifics of your situation and you should discuss your specific situation with your PCP.
I’ve seen Dr. Kevin Harris and he’s a cardiologist that specializes in athletes and had a pretty good feeling about him until he has his nurse call me to inform me that he was putting me on Lipitor for a borderline cholesterol test. Never once talked to me about my diet and went right for the drugs. So he’s got a good background but be aware he might be the kind of guy to robotically suggest a treatment plan based on where you happen to fall in a chart.
EDIT: I will say he did spend a fair amount of time talking to me when I was in the office with him. Never felt rushed there so that’s also a plus. I’m also still seeing him on a “trust but verify” status.
Thanks for the info. Yeah not sure where to turn. I just have this feeling after hard rides like I can feel my hearbeat while laying on my side way too much. It’s not really pain - it’s like my heart is saying I’m freakin beating over here - like it’s pressing somewhat against my ribs. It’s just super freaky to the point where it interrupts my sleep/recovery. My doc ordererd labs and stress/nuculear and everything has come back fine…