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What Happens During A Lexiscan?

8/1/2018

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With all the tests completed and in tow, I stepped into my first appointment with my cardiologist feeling nervous and apprehensive.  Surely, this must be a mistake as I feel I take really good care of myself.

Within minutes I was hooked up to the office EKG.  There were murmurs as the staff recorded results, "Yes, that was noted on the 24 hour holster monitor, too."  Sadly, something was astray.  

The cardiologist arrived shortly afterwards and began analyzing my testing results - looking back to previous years testing, too, to piece this all together.  After several minutes he looked up at me and smiled and said, "Yes, this was good timing on your part.  You needed to see me now so that we can get things under control." I can't tell you it was a comforting statement, but at least I knew i wouldn't end up in the ER with a heart attack. 

We went over my recent blood levels.  "These are way too high!" he exclaimed.  "We need to get things under control. Have you tried low-carb eating?" 

"Well, yes, I don't eat many carbs at all to begin with," I attested. "In fact I have been working on more of a vegan approach, but it doesn't seem to be helping with weight reduction.  I've noticed I feel lethargic and steadily gaining a couple of pounds every few months."

"Have you heard of the Paleo diet? No grains?" he asked.

"Well, I barely eat a 1/4 cup with meals to begin with because of weight gain.  I try to round out with wholesome vegetables and good protein sources," I retorted.  "I don't see how eating even less is going to help."

He swiftly walked out of the room and brought back a pamphlet.  "Read this, try it.  See what happens.  You have to do something to take the weight off to stabilize your uncontrollable blood pressure." "You have a Left Bundle Branch Block. Your blood pressure is off the charts throughout the day and causing this. I am going to order a Lexiscan to see how extensive the damage is," he said.  

Left Bundle Branch Block (LBB)

Bundle branch block is a condition in which there's a delay or blockage along the pathway that electrical impulses travel to make your heart beat. It sometimes makes it harder for your heart to pump blood efficiently through your body.

The delay or blockage can occur on the pathway that sends electrical impulses either to the left or the right side of the bottom chambers (ventricles) of your heart.

Bundle branch block might not need treatment. When it does, treatment involves managing the health condition, such as heart disease, that caused bundle branch block.

In most people, bundle branch block doesn't cause symptoms. Some people with the condition don't know they have a bundle branch block.

Signs and symptoms in people who have them might include:
  • Fainting (syncope)
  • Feeling as if you're going to faint (presyncope)

"But I have severe chemical sensitivities!" I whined.

"We need to be PROACTIVE.  This is something that needs to be done so I can help you.  I can't see what's going on without this test.  You are an educator.  Trust me, I loved my teachers.  I take good care of them. I am going to do the same for you," he exclaimed.  "It's going to be OK."

I was soon whisked off to the scheduling desk in tears knowing that this is not going to be the greatest experience, and it will take numerous days to get well afterwards. 

Lexiscan

A Nuclear Sit Down Stress Test or Lexiscan stress test, or LEXI, is designed to evaluate the condition of your coronary arteries.  These are the arteries that supply the heart itself with blood. This type of stress test is given when the Cardiologist feels that you may not be able to walk to an appropriate level of exercise on a treadmill.  This may be due to: arthritis, poor conditioning, the use of certain blood pressure medications that prevent your heart rate from increasing with exercise,  or the use of devices like a pacemaker of defibrillator.

​
Lexiscan is a prescription medication used in a cardiac nuclear stress test. It works by increasing blood flow in the coronary arteries. Lexiscan is given by IV in preparation for a myocardial perfusion imaging (MPI) test. This uses a special camera to take pictures of your heart, giving your doctor detailed information about blood flow into your heart.

Using a special type of imager, a small amount of radioactive tracer is injected into your blood before and after an injection of a medication called Lexiscan, and pictures are taken of your heart muscle.  Lexiscan replaces the physical act of exercise, and elicits the same response from your body that would occur if you were actually exercising. The pictures that are taken before and after the Lexiscan injection are then compared to each other, to see if there are any differences. Such differences in the pictures helps your cardiologist determine whether there are may be any major blockages in your arteries.  They can also see if there has been damage to the heart muscle after a heart attack.  It will also help them determine the best type of treatment you may need to correct any abnormal finding. Treatment options may include medications, dietary and lifestyle modification, or perhaps a cardiac procedure such as an angioplasty or coronary artery bypass surgery.

There are different reasons why your cardiologist may want you to have a LEXI and these may include:
  • symptoms or signs suggestive of coronary artery disease (CAD) such as chest pain, shortness of breath
  • significant risk factors for CAD such as smoking, high blood pressure, high cholesterol
  • assessment of your condition after a cardiac procedure such as bypass surgery or coronary angioplasty
  • clearance for certain surgeries that are determined to be of intermediate to high risk

​If your doctor recommends a stress test with Lexiscan, it may reassure you to know that it's a noninvasive test, meaning it doesn't involve a surgical procedure.

Here's how it works:
  • You'll be awake the entire time, and either lying down or sitting up in a chair. Your heart rhythm, blood pressure, and oxygen levels will be monitored during the test.
  • A catheter (small needle) is placed in a vein in your arm. Lexiscan is injected through the catheter into your bloodstream for about 10 seconds, followed immediately by a saline solution to clear the intravenous (IV) line. Lexiscan dilates the coronary arteries to allow increased blood flow to the heart.
  • 10 to 20 seconds after the saline solution, a small dose of radioactive isotope imaging tracer material is injected into the catheter.
  • After the tracer is absorbed in your system and distributed in your arteries, a special camera will take detailed pictures of your heart. The pictures will show how well blood flows into your heart and if there are any areas of blockage. While you lie on your back with your arms above your head, the camera will take pictures for about 20 to 40 minutes.
  • One set of images will be taken when Lexiscan is active in your system, and a second set of images will be taken when you're considered at rest.
​
The receptionist at the scheduling desk was well-informed and supportive.  "No worries," she stated.  "You can call our nuclear department with any questions.  They will walk you through everything."

I began to leaf through the pamphlet "Robb Wolf's Paleo Diet Quick Start Guide".  Have I been going about it all wrong?  I know a vegan diet is healthy for many individuals.  I've seen the results from readers here.  But, we are all wired differently.  Maybe I am not seeing the vegan results as others because my body does not respond well to grains.  Is this a possibility?  I am always willing to go full-force when trying anything new.  I made a mental note to pick up Paleo living books from the library along with Robb Wolff's The Paleo Solution. I had a week until my Lexiscan - let's see what happens.  I'm game for anything at this point.  

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