Don't stress it: Treadmill tests are your heart's friend

February 4, 2009

stress test“Listen to your heart” may be a line from a pop song, but paying attention to your heart is crucial for pilots. And, as February is American Heart Month, now is the best time to evaluate your lifestyle habits. Are you exercising and eating properly? Does cardiovascular disease play a role in your family’s history? If so, you need to pay close attention to what your heart may be telling you.

AOPA Media Relations Director Chris Dancy, who has been flying since 1999, recognized the warning signs of cardiovascular disease and was able to stave off a heart attack by taking action.

Dancy, 49, has a family history of heart disease and had familiarized himself with the symptoms, which can include but are not limited to chest or arm pain. In late 2003 he began experiencing chest pains during exertion, such as a brisk walk or when shoveling snow. He went to his family doctor but, because he wasn’t exerting himself during the examination, no symptoms were apparent during the visit. Given his family history, however, Dancy’s physician sent him to a cardiologist for an evaluation and a stress test, which Dancy equates to “a brisk walk on a treadmill with wires trailing off you.”

The Bruce protocol stress test is the most commonly used for graded exercise stress testing. As you walk, an electrocardiograph monitors your heart via electrodes attached to your body. The test consists of three stages at three minutes each, for nine minutes total. The point is to stress the heart and circulatory system to determine the quality of blood supply getting to the heart muscle, and to identify possible blockages that could be compromising blood supply to the heart. AOPA’s Medical Certification Department has additional information about stress tests on AOPA Online.

A high heart rate during the test may result in an abnormal response that could reveal coronary artery blockage or rhythm irregularity. In Dancy’s case, “I didn’t even make it six minutes,” he says. The medical staff who administered the test immediately saw signs of blockage, and after it was confirmed, Dancy underwent a cardiac catheterization. Based on the position of the blockage, his cardiologist recommended bypass surgery as opposed to angioplasty (a non-surgical technique for opening a blocked artery) or a stent, which is a tube that is used to keep a blocked artery open.

Six months after the bypass procedure, a follow-up stress test indicated “things were basically as good as they were in that first stress test after surgery,” Dancy says. He was able to get a special issuance medical certificate. Read his account of this process in the August 2004 “AOPA Pilot” article, “ Having the Heart to Fly.” Remember that the experienced staff of AOPA’s Medical Certification Department are available by telephone to walk you through what you’ll need to do to obtain a special-issuance medical. Call them weekdays at 800/USA-AOPA.

If a stress test is on the horizon, don’t avoid or delay it. As Dancy says, the stress test is more time consuming than anything to be concerned about. “You have medical personnel there the whole time,” he points out.

Jill W. Tallman

Jill W. Tallman | AOPA Technical Editor, AOPA

AOPA Technical Editor Jill W. Tallman is an instrument-rated private pilot who owns a Piper Cherokee 140.