A Sideways Glance with Richard Bogartz: Stressing the stress-test

  • laptop computer monitors a patient's heart function as he takes a stress test while riding a stationary bike in Augusta, Ga., in 2014. AP Photo/The Augusta Chronicle, Michael Holahan

Thursday, March 03, 2022

Let’s glance askance at the Sideways Glancer.

   Since before the pandemic I’d been experiencing a dull presence in       the upper left portion of my chest, seemingly high in my left lung. I’ll call it pain though it was more a dullness. There was also a sensitivity in the muscles on the exterior in that region that helped my denial.

Sitting or lying, no pain. Walking around the house, gone. It appeared only when I’d go for a longer walk. At the high school track after a quarter to half a lap, there it would be. I’d stop, sit for five minutes, and it would dissolve. I’d finish the lap, rest, then start another lap. I might finish the second lap without pain or have to bend over for a minute and then finish. By the third lap I could walk without pain.

Naturally, cardiac concerns arose. My usually reliable, but in this case befuddled, denying, intuition persuaded me that a third lap should stress my heart more, so if this were heart trouble, the pain should not be gone by the third lap but should be greater. Also I had no experience of pressure in the chest that’s supposed to accompany heart difficulty or imminent heart attack, so I Googled for something else that could produce the effect. I found it.

Exercised induced bronchoconstriction. Alas, the article failed to mention this is another name for an asthma. If it had, I might have had doubts.

Eventually, after waiting too long, and more pain, I went to tell my doctor. She was unavailable. An alternate doctor urged me to go to Cooley Dickinson Hospital for a stress test. He enumerated the possible outcomes, finally getting to bypass surgery. In an outwardly bold, inwardly cowardly, idiotic display of denial I decided not to do that yet. He then urged me to start taking 81 mg. aspirin. I did that for a while. The experience improved.

With more time, it got worse. For some forgotten reason I quit the aspirin. Eventually, I was back with my doctor and she urged me to get the stress test. Being stress-avoidant, with trepidation I did. My younger son helped by telling me about an acquaintance of ours who had died during a stress test. Later the cardiologist assured me he had never seen someone die in a stress test.

On Thursday, Feb. 3, I survived the stress test. I learned the treadmill stress is to get your heart going so that a humongous camera can take pictures, before and after the stress, of what’s going on arterially, using radiation from a radioactive dose previously injected into an IV to produce something resembling an X-ray with the rays going from inside out.

My cardiologist said it looked like 90% blockage in my left anterior descending cardiac artery. 90%! Then, wonderfully assumptively, he informed me he would schedule a diagnostic catheterization for Feb. 8 at Bay State. My denial balloon popped. I didn’t hesitate.

The chest event now acquired its proper name: angina.

At Baystate they entered my right radial artery at the wrist. An attendant showed me the entry wound size by touching the tip of a ball point pen to a piece of paper. The dot was the size. The probe carried a stent collapsed around a balloon to the blocked artery. They found 80% blockage. At the blockage, the balloon inflated and expanded the spring-like stent, resembling a circular fence, that locked into place inside the artery. Then the balloon was deflated and removed.

They kept me overnight in a torture chamber fiendishly designed to prevent sleep. The bed changed shape every 15 minutes or so; the roommate’s alarm went off; my alarm went off if I incorrectly moved my left arm with the IV; as I dozed, someone came in and turned on the lights, seeking a blood sample or a blood pressure reading. And the bed was too short. I know this was all proper and appropriate care and I overflow with appreciation and gratitude, but more so in retrospect than while undergoing it.

Dear readers, I present this adventure that, so far, is going well, to urge you not to follow in my footsteps. If your chest hurts, do whatever is needed to find out why. Do it immediately.

I was foolish. I was lucky. I am grateful. Especially grateful to the doctors, the nurses, and all their associates for their fine work, their care, and concern. And of course grateful to my guardian angel.

Richard S. Bogartz is professor emeritus of psychology at the University of Massachusetts Amherst.