Brief Answer:
My opinion as follows:

Detailed Answer:
Hello!

Welcome again on HCM!

Regarding your new question, let me explain that your doctor is right when recommending you to undergo an exercise cardiac stress test.

Reviewing cardiovascular reaction during stress test (looking for potential cardiac ischemia evidence, exploring chronotropic and blood pressure response as well as your maximal physical capacity) would clearly conclude or exclude a possible cardiac implication on you mild and nonspecific chest discomfort.

Now, returning to your exact point of concern: caffeine when on exercise stress test, I could say that it would not distort the validity of stress testing (as it would not produce false ischemic ECG changes in an otherwise, normal individual).

Nor it would make impossible physical exertion or impair your exercise capacity.

But, from the other side it would produce false results in regard your chronotropic response, your exercise capacity evaluation and also on blood pressure response during exercising.

Several studies have shown that caffeinate drinks may help nervous system during several daily commitments by improving overall performance.

But it (caffeine) also my decrease coronary flow reserve, which is not a good thing to happen during physical exercise engagements.

So, to summarize, taking exercise cardiac stress test when on caffeine effects would not produce false results of a cardiac ischemia implication on your recent symptomatology, but would interfere with the evaluation of several other important indicators of your cardiovascular well-being.

It is true that your daily reality is being expressed when on usual doses of caffeinated drinks, but as caffeine increases blood circulating catecholamines effects and exercise stress testing do the same, then it would be difficult to whom could those test results be attributable (to caffeine?!! exercise testing?!! both of them?!!).

So the matter would be more complicated.

The general recommendation is to avoid caffeinated drinks within 24 hours from the beginning of exercise stress test.

My opinion is that your should reduce you daily caffeine intake (it may trigger may adverse effects, anxiety besides them).

Though caffeine may have been taken the evening before the test, I would encourage you to avoid at least in the morning of the test day.

In such way a more realistic and properly measurable view of your cardiovascular reaction during daily stress would be achieved.

That’s my opinion.

Hope to have been of some help to you!

I remain at your disposal for any further discussions.

Wishing you a pleasant weekend,

Regards,

Dr. Iliri

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