Be Aware If You Passed Your Treadmill Stress Test

Having his heart's functions checked

When I first started working in cardiac rehabilitation as a new college grad, one of my Phase 3 cardiac rehab patients had a heart attack when he was only 35 years old. If that wasn’t unsettling enough, he had his heart attack the DAY AFTER he “passed” his treadmill test. Back then, I couldn’t understand how that could possibly happen, but I now know better.

How Sensitive Is Your Treadmill Test?

Here’s what you need to know. Currently, the exercise ECG is the most cost-effective first-line screening tool, but its accuracy relies on the ‘sensitivity’ of the test. Sensitivity refers to the percentage of cases in which exercise testing accurately identifies the presence of coronary artery disease (CAD). Unfortunately, the exercise ECG it is not 100% sensitive to detecting coronary artery disease. 

Per the American College of Sports Medicine, the current sensitivity for detecting CAD using the exercise stress test is only about 70%.  In other words, if you test 100 cardiac rehab patients with documented coronary artery disease, only 70 patients would show evidence of CAD per the stress ECG test. If you’re one of the 30 remaining patients, where does that leave you?

False Negatives

Well, don’t start your celebratory dance (or meal) just yet. It just means that you may fall in either of the following groups:

  1. You have a negative stress test. That is, you actually “passed” and show no signs of coronary artery disease.
  2. You have a false-negative finding. This means you’ve been given a negative stress test result (normal) where no CAD ‘appears’ to be present, but you actually have CAD.

The bottom line… a negative exercise ECG test is no guarantee that you do NOT have coronary artery disease (CAD) even if your cardiologist tells you, “Everything looks great! See you in a year.” So sorry to burst your bubble, but that’s the reality. Cardiac events that occur after a negative stress test happen all too often, but it’s not so perplexing to me anymore.

Causes of False-Negatives (Lower Sensitivity)

Stress test results are only as valuable as your performance, the technician’s monitoring, and the test interpretation. Here are some factors that may increase your chances of a false-negative finding:    Continue reading “Be Aware If You Passed Your Treadmill Stress Test”

Weight Train After Your Heart Attack and Live Longer

Man has heart attack

After your heart attack or some other “cardiac event”, such as a coronary artery bypass graft and/or stent placement, you may have received conflicting advice as to what level of activity is acceptable. Some of the things you may have heard are:

  • Don’t lift anything over 5 lbs.
  • Don’t lift anything over 10 lbs. “for a while”.
  • Don’t lift anything for a week.
  • Don’t drive more than 30 minutes.
  • Don’t “get exhausted” for a month.
  • Don’t exercise for a few weeks.
  • Don’t lift over 5 lbs. for a period of time — or ever.
  • Go back to whatever you were doing before.

These guidelines can be confusing and promote anxiety and inactivity. Physicians generally prescribe aerobic/endurance exercise, such as walking, to strengthen your cardiorespiratory system, but in order to return to activities of daily living (ADLs), resistance training is necessary to accomplish everyday tasks, such as:

  • Mowing the lawn
  • Vacuuming
  • Carrying your children, groceries, or suitcase
  • Loading and unloading the trunk of a car/truck
  • Bending over to pick up the newspaper or toys off the floor
  • Lifting your grandchildren
  • Placing or removing items from a high shelf
  • Closing the trunk of a car or van
  • Opening a heavy door (e.g., door of a car, building, refrigerator, freezer, or dishwasher)

Resistance training enables you to perform these daily tasks safely, independently and more efficiently. By having a stronger musculoskeletal system, you decrease the cardiac demands of daily activities and increase your endurance capacity for other activities. Strength training has also been shown to maintain and build stronger bones as well as slow or prevent bone loss. A strong structure will reduce your risk for developing other debilitating diseases (e.g., osteoporosis) and ultimately help you live a longer, stronger and happier life.

Grandparents And Grandson Playing Game Indoors TogetherMuscular strength and endurance are important to prevent falls and safely return to vocational and recreational activities as well as activities of daily living. Most people need to do some type of lifting, carrying, or pushing in their daily routine. Your body has nine (9) fundamental human movement patterns. The foundation of your workouts should develop these movements:    Continue reading “Weight Train After Your Heart Attack and Live Longer”

♥ Daily Dose | How to Shop for Whole Grains

Is this a whole grain?
Is this a whole grain?

Following an eating plan that centers around whole-grain foods versus refined grains can help you reduce belly fat and other health risks.  See Eat Your Way to a Trimmer Waist. But shopping for whole grains can be confusing with all the varying descriptors. So here’s a guide to help you decipher what’s whole grain and what’s not.

To qualify as a whole grain, 100% of the original kernel – all of the bran, germ, and endosperm – must be present. All grains start out whole, but during the refining process, the bran and germ are removed. As a general rule, look for the key word “whole”, such as “whole grain”, “100% whole grain”, or “whole wheat” when shopping for a whole-grain product and see that it’s listed as the first ingredient on the food label.

Watch for These Words

Beware of the following product ingredient descriptions as they MAY NOT be whole grain:   Continue reading “♥ Daily Dose | How to Shop for Whole Grains”

♥ Daily Dose | Eat Your Way to a Trimmer Waist

Beer Belly_istock_000015992739xsmall_A large waistline (abdominal obesity or “having an apple shape”) puts you at risk for cardiovascular disease, high blood pressure, stroke, high cholesterol, and type 2 diabetes — all of which can affect your longevity. Belly fat is also one of the risk factors for metabolic syndrome. See Daily Dose | Why Metabolic Syndrome Matters.

A study published in the American Journal of Clinical Nutrition (Katcher, H.I. American Journal of Clinical Nutrition, January 2008; vol 87: pp 79-90), found that a calorie-controlled diet* rich in whole grains decreased extra fat from the waistlines of obese subjects with metabolic syndrome compared to dieters who ate refined-grain foods.

*Daily energy needs minus 500 calories per day were calculated to produce a calorie deficit needed to achieve weight loss.

The Whole-Grain Diet

A grain product is whole grain if a “whole grain” is listed as the first ingredient on the food label. By following the whole-grain eating plan, participants lost more abdominal fat than another group that ate the same diet, but ate refined grains instead.

To replicate the study, eat the following daily for 12 weeks (the participants lost 12-14 pounds):   Continue reading “♥ Daily Dose | Eat Your Way to a Trimmer Waist”

♥ Daily Dose | Golf and Sudden Cardiac Arrest

Did You Know…

golf-course-landscape_PDGolf courses are the fifth most common place for people to suffer from sudden cardiac arrest (SCA). SCA is a condition in which the heart suddenly and unexpectedly stops functioning. According to the American Heart Association, a golfer is one of over 380,000 people in the United States each year to suffer from out-of-hospital sudden cardiac arrest… and less than seven percent survive. The other four most common places for SCA are airports, shopping malls, stadiums, and jails.

How to Be Prepared

The worst case scenario is having a cardiac event on a distant hole. On your next golf outing, it’s a good idea to do the following when you schedule your tee-off time:   Continue reading “♥ Daily Dose | Golf and Sudden Cardiac Arrest”