Truck drivers and gardeners

June 25th, 2006

When I was learning about Cardiology at our local General Hospital I had to become proficient in performing exercise tolerance tests (ETT’s) on patients with chest pain, or who were recovering from heart attacks.

ETT’s, commonly known as stress tests, are undertaken by wiring a patient to a specialised ECG (EKG) machine that analyses the electrical activity of the heart in real time, whilst the patient undergoes progessively more strenuous exercise on a treadmill.

Those suffering from coronary heart disease cannot deliver enough oxygen to their heart muscles as the level of exercise increases, which is detected by small changes in the ECG trace. This is termed ST segment anaylsis and is a reliable indicator that coronary heart disease is present.

In my time at the hospital, I performed hundreds of these ETT’s on a whole range of patients, mostly those who had some form of chest pain.

Of course, chest pain, of any sort, should be taken very seriously, particularly if it occurs in middle aged men who have a high risk of heart attacks. It is the hospital’s policy that these people should be seen as soon as possible and undergo an exercise tolerance test to detect, or eliminate, coronary heart disease as a cause.

As I performed hundreds of these tests, and became proficient in detecting small changes to heart activity, and diagnosing coronary problems, one major factor started to shine through.

By and large, what one does for a living determines how healthy we are, particularly with heart disease and conditions such as high blood pressure.

I saw many patients who lead sedentary lives, particularly truck drivers who spend all day driving, often in stressful traffic conditions. As truck drivers generally enjoy cooked breakfasts and fast food from “greasy spoon” restaurants, they often have unhealthy diets along with prolonged periods of inactivity. Almost invariably, middle aged truck drivers were diagnosed with coronary heart disease when attending our ETT clinics.

Another group stood out too - those who had active outdoor jobs. I tested quite a few people who were professional gardeners and landscapers. They presented with chest pain, but generally were amazing on the treadmill. Used to physical work, they could undergo high levels of exercise without showing any coronary problems at all.

Their chest pain was probably due to muscle strains and other factors of “non cardiac origin”.

I learnt a valuable lesson when running that clinic. Keep those coronary arteries in as good a condition as you can, by leading an active life and eating a healthy diet. Couple that with as little stress as possible (which is difficult) and you might get through life without encountering someone like me during an exercise tolerance test.

Entry Filed under: Affairs With The Heart