The Stress Test

There’s a lot of data here.  The fading of the line across the strip of the charts (ink mark) kind of suggests that it all came from the same tracing.  The reported value for the maximum achieved heart rate by the end of level 2 (160) on the Bruce protocol is 92% of what I was predicted to be able to achieve (173), this percentage is consistent with what I was told at the time by the attending. The actual value (160) seems low to me.  I have regularly worn a heart rate monitor on my wrist under less stressful conditions in the past and it gets up pretty high pretty fast.   I don’t really know if I should have gone that high under these circumstances.

The notch in the P wave on lead 2 is really only present in the summary of the data, not seen in any of the actual data files.  This notch is consistent with the tracing I was given at the ER – that is my former tracings.  The data here clearly go through a filter (probably because I am exercising) that one doesn’t see in the ER.  It may also simply be averaging of several tracings.

summary of data (has notch in P wave):

IMG_0839

The lead II EKG at 0:00 min (beginning of stage 1) reported in the summary.

pwave_start_sum

The lead II EKG at 5:50 min (end of stage 2) reported in the summary.

pwave_end_summary

Below: the “absent notch” p waves from the data at the start of the test where the anticipated notch in the p waves would seem most prominent from the summary.

pwave_from_data_start

The blood pressure values reported over the course of the test were:

175/88 starting the test and standing (time 0).  106 bpm.  Consistent with what I was told.

201/74 at the end of stage 1 (time=3 min. with 1.7 mph, 10% grade). 150 bpm (Systolic is consistent with what  I was told, I don’t know about the diastolic).

The data at the end of stage 2 is missing from the file report.  The systolic that was reported to me during the test was 219.  I was too disoriented to remember to ask for the diastolic and heart rate at the time.  I was worried about my systolic.

238/103 reported about 1.3 min. after test stopped during recovery.  About 135 bpm.  This is derived from the data.  The value reported in the summary is only the very last measurement after 7 min.

195/91 reported 7 min. after test stopped during recovery.  About 101 bpm.

If these values are correct, then there is an abnormal blood pressure response that needs to be explained at higher stress levels.  I made it up to 7 METS with difficulty, which, although not the 8 METS needed to be “out of the red zone“, is still above the 5 METS threshold.  I guess this means that the highest I went during the test was 7 times my resting exertional rate.  Trying to figure out what’s normal here.  The link in the sentence before, has a table of activities that are rated by MET levels.  I think with blood pressure medicine, I can probably do slightly more than 7 METS.  I have to stop a few times when climbing lots of stairs, and jogging is probably not a good idea for me.  Raking leaves is probably ok, but it is rated 8 METS in the chart.

The sampling of the data, appears to be irregular to me, that is that there are time sampling points that are logically not present in the data (times given to me were 0, 50s, 1m24s, 1m50s, 2m50s, 3m50s, 4m50s, 5m50s, 6m01s, 6m10s (peak), 0m07s(recovery), 0m31s, 0m50s, 1m23s, 1m50s. 2m50s, 2m59s, 3m50s, 4m50s, 5m50s, 6m08s, 6m50s).  Basically, it would logically seem to me that data from 4-6 min be more systematically sampled.    I would appreciate the actual CD.

In terms of what I was given:

Here is the standing start of the test,

 IMG_0814

 


the 2 min. 50s mark (10 sec before the end of stage 1),

IMG_0819

below: the point where the test was stopped:

IMG_0823

below: the peak physiological values (heart rate) given to me (10 sec. after stopping).

IMG_0825

below: 1 min. into the recovery,

IMG_0827

below: the peak physiological values (blood pressure) given to me (1 min. 23 sec after stopping).

IMG_0828

below: 7 min. into the recovery.

IMG_0836

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