Stress tests and cardiologists

The fact that my blood work was great at my last physical last month was overshadowed by what my doctor called an atrial flutter, an abnormality in my heart.  Anytime someone says "heart" and "abnormality" in the same sentence it gets my attention.  So I had to see a cardiologist and have a stress echo test.  I had heard about these, and what I heard didn't induce a lot of comfort.  Basically I was told it involves walking on a treadmill at increasing effort (the stress part) until you reach "maximum effort."  Nowhere could I find what "maximum effort" meant, so I was left to imagine walking until I puked, fainted or died, whichever came first.

When I arrived, I asked what maximum effort meant and was told that it means getting one's heart rate up to 90% of maximum, which the cardiologists define as 220 minus one's age.  In my case, that is 160 beats per minute.  I immediately felt better.  Having done heart rate monitor (HRM) training, I know what 90% of maximum heart rate feels like.  It's work, but not my idea of maximum effort (for that opinion, see above).  The test starts by being attached to a bunch of electrodes and lying on my side while a technician makes an ultrasound of my heart.  This lasted about 20 minutes, during which I nearly fell asleep.  Then the test came.  The treadmill started slowly but every three minutes the incline and speed increased.  Once I hit my maximum, I jumped off the treadmill and back onto the table so the technician could take another ultrasound of my heart under stress.  She had 60 seconds to do this.  The worst part was when they told me to hold my breath.  Imagine being out of breath and being told not to breathe.  After the test was over, they told me I could go and someone would call.  The good news was they didn't look at the results and say, please sit down and the cardiologist will be right in.  Apparently I was healthy enough to leave.

Eventually I met with the cardiologist who confirmed an atrial flutter, meaning the upper chamber of my heart, the atrium, is not pumping regularly; it's just fluttering.  As he put it, I have 25% of my heart not working properly, which could explain my lack of endurance this year.  I attributed it to lack of training.  The cure is to have my heart shocked back into a regular rhythm.  To do that, I first have to thin my blood so a clot doesn't develop, which could lead to all sorts of nasty things.  So I'm on a blood thinner, warfarin, which is the generic for coumadin, a long-used blood thinner to help prevent strokes.  Warfarin is the basic active ingredient in rat poison.  It works by thinning the rat's blood so much that it leaks out of its veins and the rat bleeds to death internally.  So I'm on a prescription of rat poison.