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Post experiences here with stress tests, both echo and nuclear (Thallium, etc.)

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Current Postings on This Page (97):

• Make sure you understand what type of test you are getting and that there is a cardiologist involved!! Above all make SURE THERE IS A CARDIOLOGIST PRESENT trust me!
Helcat, Helena, Alabama, USA, April 17, 2013

Twolfe, Santa Ana, California, USA, February 24, 2012 -- Why on earth would you consent to taking statins given your good health status? brwneyedblnde, Tucson, Arizona, USA, July 28, 2012 I'm sorry no one responded to this post. Of course the transducer pressure shouldn't have been painful. But what I want to know is what happened to this poster in the last year. Morever, sick and disgusted with patients being sent home without one word of explanation if you fail to "fail" the blasted tests in a big enough way to let standard-operating-procedure take the lead.
ohbrother, Rockport, Texas, USA, April 14, 2013

• Hi, I had an exercise treadmill test and an Echo several months ago. The cardiologist advised that everything was normal and my treadmill was satisfactory, although I did have tendency to extra beats during exercise She wants me to have a stress/rest MIBI to further clarify the blood flow to my heart. Assuming I'm going to get about 12msv, is this really necessary? I never get chest pain.
Mark, Cannock, United Kingdom, April 9, 2013

• Sinodog in China -- Certainly the language barrier presents difficulties. There's the possibility that, if you are having palpitations, you may have some rhythm or valve issues. Echocardiography stress test would most likely show if there's a problem there. If it's a coronary blockage that is reducing the flow of blood (and therefore oxygen) to the heart muscle, you might be experiencing angina. Two non-invasive tests for this are a nuclear stress test or a Cardiac CT angiogram (not a "full body scan" or Calcium score). You can read about these in our "Imaging and Diagnosis Patient Guide."
Angioplasty.Org Staff, Angioplasty.Org, March 21, 2013

• I am a 52 yr-old male living in China. Concerned with chest twinges and increasing fatigue. This week I went from one hospital to another trying in vain to get some adequate care: communication problems, my Chinese isn't great. Nobody spoke English. My tests, ECG, blood work and ultrasound all negative. I have palpitations and fear of doom. I really don't think I'm imagining it. One cardiologist wanted to do a CC at once; it made me distrustful since my understanding was that without some kind of evidence of blockage from the tests they don't do that. If only I had someone to talk to about it. I'm going quietly mad with worry. Thank you for any feedback.
Sinodog, Nanning, Guangxi, China, March 9, 2013

• Vcheart in New Jersey -- We assume these were nuclear stress tests. These show if there is a "perfusion deficit" (reduced blood flow and oxygen supply) to the heart muscle -- and your latest one indicated that there might be. The next step is a matter of some debate in the cardiology community. Your weight and family history are two risk factors, as is the change in the perfusion. One possible alternative to an invasive angiogram (a.k.a. catheterization) might be a Cardiac CT Angiogram with contrast. This is non-invasive, takes only a few minutes and is considered to be 99% negative predictive -- i.e. if the CT test shows no narrowings, there are no narrowings. This saves having to do a more expensive and invasive angiogram. The downside, however, is that Cardiac CT is probably not covered by insurance and, if a narrowing is seen, you may have to go on to get an angiogram anyway to confirm: more costs and more radiation. Additionally, if based on the findings, an intervention (stent) is considered the correct treatment, it is possible to do it in the same session as the angiogram. This is called an Ad Hoc Angioplasty (see the latest information on Ad Hoc Angioplasty) and is something that definitely should be discussed with your cardiologist BEFORE the angiogram.
Angioplasty.Org Staff, Angioplasty.Org, February 17, 2013

• I had 3 stress tests all normal. I am 50 yr old male non smoker low cholesterol. But overweight and heart disease is in my fathers family. The recent test showed the u shaped picture was no longer perfect and one side was now shorter than the other. I have no other symptoms I am being told to go for angiogram; is that prudent next step?
vcheart, Princeton, New Jersey, USA, February 17, 2013

• Concerned son -- Very sorry for your loss. While stress tests can't measure how blocked an artery is, one would think that two completely blocked arteries would show up somehow. But it may be that these were old blockages and that your father had developed collateral circulation, kind of a natural bypass, and therefore no problems showed up on the stress test (a stress test does not actually image the arteries, just if there is a problem with the pumping). However, stroke is a known complication of carotid surgery (and carotid stenting). If a small piece of plaque breaks off, it can shoot up to the brain and cause a stroke. Impossible to say what happened in your father's case.
Angioplasty.Org Staff, Angioplasty.Org, January 20, 2013

• My dad (80 yrs. old) had a carotid blockage and went thru a stress test before surgery. They said everything was fine. During his surgery he had a stroke. Then overnight he had a heart attack. That is when they found out 2 of his heart arteries were almost completely blocked. How could they have missed these blockages during the stress test? He later passed away.
Concerned son, York, Pennsylvania, USA, January 6, 2013

• I had a heart attack 2 weeks ago and had 3 stents put in. I drive a commercial vehicle and want to return to work in another week. Can anyone tell me if my license is suspended? The Dr advised me not to drive and have not received any letter from DMV to advise.
Mustard, Halifax, Nova Scotia, Canada, January 1, 2013

• Just wanted to say that I had an echo stress test this week and three days later my left breast (I am a female) is black and blue where the tech probed so hard with the ultrasound wand. I almost feel like my ribs could be bruised. Yes, very painful test! I guess sometimes they have to probe that hard to separate the ribs a bit under the breast tissue for better pictures. I was also told my "implants" might make the test worse - and I don't have implants!!!!
Zoey, Detroit, Michigan, USA, November 23, 2012

• What drugs should I stop before a nuclear stress test? I take Plavix, atenenol, imdur???
Sally, Toms River, New Jersey, USA, September 21, 2012

• I am 36 year old female I have facing problem of deep respiration and chest pain with heavyness and i did not pickup light weight and long movement. When upstraight of stair problem creat that time. Treatment is going through two cardiologist as per advise of doctor ECO, TMT ,PERFUSION SCAN WIT TMT and Blood profile are normal . Medicine taking as per instructin of cardiologist.1. Proxmy xt, nitrocotine 2.6 mg, ASA and AMIFRUE for one month , but my problem is not furnish. please advise the reason of problem and treatment , test etc.
Angiography, House wife, delhi, India, September 5, 2012

• I recently had a stress test and was not told not to take my blood pressure meds so I did not pass that test and went back the next day for a second test. I passed that test. Not sure how long it took me to reach the target point but was very much out of breath. When I finished they said I passed. I am concerned b/c I am still short of breath and have a heavy/bloated feeling in my chest along with discomfort in my middle back. Any recommendations would be appreciated. I don't want to feel like I am looking for something to happen but it scares me at time. Also short of breath with I lye down at night to sleep. I have only had a couple of pains but I take nexium for serious indigestion. I still have indigestion taking the medicine at times but the medication helps a lot. Thanks
Concerned 54 yr old female, Loganville, Georgia, USA, August 21, 2012

• Helo I am going in for a stress test. They said they will be giving me a shot. Because I can walk. Two part test. 1 Go in for the shot and they will check it out. And then a week later go in for a altersound. I had a EKG At my doctors he said it didn't look like the last one I had done. Has anyone had one done with the shot for the stress test. What do you think? Anything to worrie about. I am 44 and can't get around. Because of my back is not getting better and other stuff. ect.
Having a stress test on aug.23 part one., Stanley, Wisconsin, USA, August 20, 2012

• I'm a 50 y/o female. I have been having major chest pain and pressure for the past few months. It began to radiate into my left shoulder and down my arm. I always felt it was anxiety but my Dad who has CHD gave me a nitro one night and it stopped my pain immediately. I began to think maybe it was my heart after all. Just to rule it out, I went to my Dr. who ended up sending me to the ER via and ambulance from his office because of a slight variation in my EKG. The ER Dr's did an Nuclear Stress Test and an ECHO (which turned out to be very painful, BTW) Are they supposed to be?? I was kind of shocked. Everything came back normal so they sent me home never explaining what the problem may have been. I have a few questions...#1-why was the ECHO soooo painful, are the tech's supposed to press that hard or do I have to worry about something being wrong with my left breast now on top of everything else? Lastly, why did the Nitro relieve my chest pain if it wasn't heart related? I had a total of 3 Nitro in an 8 hour period! If it is anxiety or anemia, I don't understand why the Nitro was so effective. Can someone help explain this to me? Thank you so much!!
brwneyedblnde, Tucson, Arizona, USA, July 28, 2012

• At 43 I had a triple by pass.6 months prior I had a stress test and past, in the wait for stress test I was given nitro. For months I was having difficulty walking and having heaviness in chest. Weeks before I woke up every night just once in the night with a breathing problem. then one day I had heaviness in chest pain in lower back, neck and shoulder. pain shot through my jaw and out my ear. took the nitro. had 2 more heart attacks at hospital, followed by triple by pass. Any women out there finding it hard to walk with pressure in chest, and lower and middle back pain, don't deny it. I did for too long to young for that. Nitro kept me going, and remember I passed the stress test. Blood test showed just over the border line so emerge ran some more test had to wait 6 hours for test to come back and while waiting had another hear attack. There was no sharp pain in chest at all just heaviness. Too many young people are having heart attacks,pay attention and don't deny it. I did for too long, and someone was definitely looking over me.
Sandi, Sprucedale, Ontario, Canada, April 26, 2012

• Mamaw3 in Ohio -- Not sure what you mean by a "medicated" stress test. Do you mean one where a drug, like adenosine, is injected to simulate the exercise portion??
Angioplasty.Org Staff, Angioplasty.Org, April 26, 2012

• My husband who had a MI 7/12, is holding fluid and easily fatigued. Dr. ordered an Echo & treadmill stress test. At his stress test yesterday, they did the nuclear part then had him walk 11 minutes on the treadmill, reaching his target heart rate. then they told him they were doing a medicated test also. Why would they do both at the same time. I did stress tests as a RN, for 5 yrs. early 2000's. I never heard of this. Any ideas?
Mamaw3, Middletown, Ohio, USA, April 20, 2012

• Unsure & confused -- Since you have high cholesterol and high BP, and are experiencing symptoms, we would most definitely recommend that you see a specialist (cardiologist) if only to get another opinion and possibly something to treat these issues. Make sure he/she has a copy of your medical records and your stress echo. Let the Forum know how you make out.
Angioplasty.Org Staff, Angioplasty.Org, March 29, 2012

• I am a 64 yr old female with high blood pressure, high cholesterol on meds. I have been experiencing heart fluttering, a thump in my chest waking me from my sleep. I recently had a stress echo test which was normal. I now have fears of going to sleep at night because I continue feel (to me) abnormal skips in heart beats. I have only seen an internist. Should I see a cardiologist?
Unsure & confused, El Monte, California, USA, March 25, 2012

• Totallymisunderstood from Manchester -- an MPI (Myocardial Perfusion Imaging) scan -- sometimes called a Thallium or nuclear stress test is described in our Imaging and Diagnosis section. It measures whether or not the heart is receiving sufficient blood supply to the viable part of the heart muscle. The doctors want to know that bypassing the arteries will increase that flow to the part of the heart that is working (each artery feeds a different section of the heart). If an artery to a damaged part of the heart is blocked, opening it up using bypass surgery or angioplasty won't really change much in his heart function. Outlook is not something we can comment on because it's specific to each patient.
Angioplasty.Org Staff, Angioplasty.Org, March 12, 2012

• My husband was diagnosed with HF in Dec 11, he has just had an angiogram which shows he has 3 blocked arteries, one is totally blocked, this with the damaged muscle means that he has been put on various medication, he has been told that he will have to have a MPI scan to determine whether or not a bypass operation is viable, I have two questions about this, First what does this scan entail and how can it help, and what is the outlook for my hb if surgery is not an option, can he continue with blocked arteries.
totallymisunderstood, Manchester, UK, March 9, 2012

• Confused in Richfield Springs -- You should discuss this with your cardiologist. The PA was just reporting the preliminary results of the tests but these need to be judged against your symptoms and other clinical data. Like any test, nuclear stress tests are not 100% accurate. Also in women stress tests can be less accurate, and sometimes angina in women comes from the microvasculature. This is an area that more is becoming known about -- especially by cardiologists who specialize in treating women.
Angioplasty.Org Staff, Angioplasty.Org, March 6, 2012

• I am 36 years old female who just had echo and nuclear stress test completed. The PA in the room said everything looked alright but I still feel heavy chested after sometimes doing nothing.
confused and looking for answers, Richfield Springs, New York, USA, March 6, 2012

• Twolfe -- Your test was for a Calcium score, and not a stress test. Check out our Forum Topic on Calcium Scoring. Calcium scoring is kind of a surrogate marker -- if you have a high calcium score, you have more risk of occlusive disease. But it is not a definitive "yes" or "no". One possible test would be a nuclear stress test. This is a functional test to see whether or not the oxygen/blood flow to your heart muscle is restricted. A visual test might be a Cardiac CT Angiogram, except that a CCTA is less accurate in patients who have high calcium scores -- the calcium blocks the CT imaging to an extent. An invasive angiogram would show any blockages, but to really know if they are significant (causing ischemia) you might need to add the use of Fractional Flow Reserve (FFR).
Angioplasty.Org Staff, Angioplasty.Org, February 24, 2012

• Recently an "Ultrafast" gave me a total calcium score of 538 with 380 of that being in the LAD. I am a runner 1 - 1 1/2 hours a day, strenuous canyon running), have run for 45 years (I'm 70), eat only veggies, fruit and fish (salmon and ahi). BMI = 19.5. BP runs about 130/80. My total Ch = 132; LDL's = 52; hdl's = 69. Heart rate averages 46 BP. Have been on Lipitor for 10 years (20 mg). My cardio just switched me to Crestor as he wants the LDLs as low as possible. Starting on 10mg and we'll go from there. Question: In that no one will send me for an invasive angio, as I've never had angina or a coronary, how can I tell how occluded my arteries are? Also,is it at all possible to reverse plaque build-up with statins? Thank you so much
Twolfe, Santa Ana, California, USA, February 24, 2012

• I have just had a nuclear heart scan and i have Ehlers-Danlos Hypermobility syndrome and very bad IBS [Irritable Bowel Syndrome]. Just wanted to warn others with IBS that it triggered very painful stomach cramps and very bad IBS symptoms when I got home last night. It was also extremely difficult to get the needle into the correct vein because of the Ehlers-Danlos - even before the procedure started.
Sasha, Suffolk, England, February 21, 2012

• Hello my name is Louie i want to know more about a heart, does your brain tell your heart how fast to pump, cause my wife went for a EKG and stress test and made her run for 5mins and her heart never raced fast and she started to sweat and her blood pressure started to drop and all most made her pass out,. And i had a CAT scan done in Cabrini hospital 15yrs ago and the doctor told me the i had 1 blockage at 20% closed, i was 23 at that time, i became a diabetic at the age 20, i was diagnosed with type 1, being on all types of insulin for 23yrs, now at age 43yrs old i went to a Dr, i had a EKG done 6 times and still had heart pains while they had test ongoing, than they did arteriogram test and let me up with the nuclear and it felt like my body was on fire , i felt my inside burning very hot and made it hard for me to breathe , and now i walk with pain in the back of my heart , now I'm on insulin novolog flex pen 20 units 3 time a day before each meal,and lantus solostar 1 time a day before bed time at 40 units, my sugar has been very good but now I'm on Lipitor 10 mg, Plavix 75mg, baby aspirin 81mg, hydralazine 25mg, OK the Lipitor is to stop further blockage, aspirin 81 is to coat your arteries and protect you from getting blood clot to the brain so you don't get a b-stroke , if you catch 1 you can die, now my doctor told me my front artery is 70% closed and back artery is 80 closed and the back of my heart is 1/4 dead, i can live on these meds for a few years until my heart gives up or i have a 50/50 chance that I'll live for another 30yrs if i get the stints [stents] put in my arteries, this will make my blood flow move faster and more air flow to the body as well , right now i can't even walk 20feet without getting tired so I'm going for this operation and let them do the 2 stints [stents] so i can live a longer life, i might have to keep taking med but at less I'll be able to live for my mom , my family and for my wife, if anyone would like to talk just email me.
Louie Marino, New York, NY, February 11, 2012

• WHReed -- The 37% just means that a little over 1/3 of patients who are sent on to cardiac cath to test for coronary artery disease (CAD) don't show any on the angio. Stress tests are known to have false positives, and more so in women. Unlike stress tests, the angiogram is a visual test where a shadow image of the arteries can be seen. If there are any blockages, they will be visible (although just because a blockage is visible, does not mean it needs to be treated with an angioplasty). So in that respect, the cath is considered the "gold standard" by cardiologists. If no problem is seen during the cath, there is no visible problem. There is the possibility that these pains, etc. may be anxiety-related, although that doesn't mean they are not real (see a post sent in today to our topic "Not Feeling Well After Stenting" for one patient's experience along those lines), Finally, there is a condition, specifically seen in women, called microvascular disease, in which the symptoms of CAD are present, but blockages are not seen on an angiogram, because the problem lies in the very small micro-vessels. Not saying this is the answer; we can't and don't offer medical advice. But, if you are still concerned, we would suggest consulting another cardiologist, specifically one who specializes in treating women. Let him/her review all the test results, stress tests, EKGs and definitely the angiogram done during the recent cath. As for not having a report, there has to be a CD or other recording of the angiogram that was made for review. And let the Forum know the outcome.
Angioplasty.Org Staff, Angioplasty.Org, February 4, 2012

• Thank you for your response, but I'm not sure what you're saying by my wife being part of the 37% negative. Does the cardiac catheterization trump all the nuclear and other stress tests and ekg where they told her she was really sick? Now the cardiologist has told her she's very healthy and there's no need for her to come back to him. Is the CC full proof? We didn't get a report of any sort that anyone else could take a look at. Just scared because my wife was experiencing chest pains and rapid heart rates on and off and that has not gone away; she still gets them and they suggested we get a gastro test now.. very puzzling... thank you.
WHReed, Colonial Beach, Virginia, USA, February 4, 2012

• WHReed in Virginia -- A study of the NCDR database, maintained by the American College of Cardiology, showed that 37% of cardiac catheterizations were negative for coronary artery disease. So your wife is part of "the 37%". We're somewhat surprised at the "leaky valve" diagnosis, because a stress echocardiogram should show pretty clearly if there is a valvular problem.
Angioplasty.Org Staff, Angioplasty.Org, February 4, 2012

• My wife, for the past two years was told by two different cardiologists that she had a left bundle block because of the results of two different Nuclear Tests, and Two EKG tests which showed she had this block as well as possible leaking valves and a weakened heart. She was told that this was an older persons disease and many just drop dead. By the time she switched to the 2nd cardiologist, once he received the same results, he then ordered a Cardiac Catheterization test. This test showed her to not have any of these problems and he told us that her arteries are perfect and there is absolutely no heart disease. My wife is stunned and trying to be happy about it but for the past two years they have had her on medication. The Dr. told her she has no need to come back. Should she be satisfied with these results, and if so, how many people could have the same bad readings and taking medications for nothing?
WHReed, Colonial Beach, Virginia, USA, February 4, 2012

• Yonas in Virginia -- Nuclear stress tests have been around for quite some time and are definitely FDA-approved. 15 msv and up is about what these tests run. It's slightly more than you would be exposed to during a cardiac catheterization or a CT Angiogram. In fact some centers have reduced CT Angios down to 3-4 msv. For comparison sake, just walking around New York City you'd be exposed to 3 msv in one year. Yes, a stress test is definitely more than that, but will one such test cause a cancer? There's no evidence that it will and, as you make reference to, pretty much the only data we have on the effects of radiation and cancer go back to atomic bomb survivors from Hiroshima. This being said, millions of patients get these types of scans and our advice was in our post from yesterday, to be conservative about when and why you get such tests.
Angioplasty.Org Staff, Angioplasty.Org, January 20, 2012

• Hello: I had a thallium stress test a few months ago and was exposed to ~17 ms V. I was wondering by how much I have raised my risk for cancer? The test I had used TI-201 isotope. Are there any epidemiological studies (animal or human) done to date to evaluate the mutagenic and carcinogenicity potential of this isotopes? If not do we use it at our own risk? Is it approved by the FDA? In addition how can one evaluate or base risk of these radionuclide based on data extrapolated from external sources of radiation (i.e. like A-bomb survivors)? Are there enough studies out there to evaluate their intracellular activities? I am hearing now that the current dosimetry underestimates the micro dosimetry by about 15 folds. If this is true; then don't you agree the risk from a single Thallium scan not to be minimal; instead to be very significant? I am hearing now The risk from this radionuclide comes in two forms: one the radiation they emit and second by the process they decay (i.e. Auger decay is highly mutagenic). I would appreciate your expert opinion on these matter.
yonas, Alexandria, Virginia, USA, January 20, 2012

• Yonas and Tasha -- Concern over radiation exposure in medical imaging tests is a hot topic (no pun intended) these days. There was much concern, for example, over CT angiography, and much has been done to reduce the radiation per procedure. The study you reference from the Canadian Medical Association is a retrospective look and has found an association between patients who had heart attacks and subsequent imaging procedures and the development of cancer later in life. The calculated increase was 3%. This is fairly low, considering the difficulty of making such specific calculations of radiation exposure retroactively. It is very difficult to measure such amounts during a procedure in realtime, so relatively broad estimates must have been made. Not to diminish any concern, but the causation of cancers from radiation is a very hard thing to show accurately, since obviously a randomized clinical scientific trial cannot be done. The best advice is to minimize the number of procedures you are exposed to, make sure they are necessary, make sure they will actually affect your therapy, and then to make sure you get the procedures done with state-of-the-art equipment that uses low-radiation dose protocols. You can read more about radiation exposure with CT (somewhat less than a Thallium test) in our interview with Dr. Michael Poon.

Tasha -- your situation is a bit different, because in a nuclear stress test, the radioactive element is in the tracer that is swallowed by or injected into the patient. We would have to assume your clinic follows the correct protocols for handling and disposal of radioactive materials.
Angioplasty.Org Staff, Angioplasty.Org, January 19, 2012

• I am new here; But was wondering if thallium stress test causes cancer (blood cancer) later in life? I saw a Canadian study online (http://www.cmaj.ca/content/early/2011/02/07/cmaj.100463.abstract). I hear the radiation from a single thallium stress test is equivalent to 1000 chest X-rays. Don't you think that is very dangerous for our blood cells? Anybody with adverse effects? As you all know it takes five years for solid tumors to develop and at least two years for blood disorders like leukemia or lymphoma or Multiple Myeloma after radiation exposure.
Yonas, Alexandria, Virginia, USA, January 19, 2012

• Hi, I work in a clinic that performs nuclear stress test. I would like to know if I am in any type of radiation danger? I also have two children at home ages 3 and 5 months. Are they in any type of danger once I come in contact with them? I am very worried about this and quite concerned.
Tasha, Bronx, New York, USA, November 18, 2011

• I am 44 years woman and recently I had my CT angiography done after stress test. The CT scan results came out normal. Exactly after a month now I am getting a constant dull pain in my chest again. When I rub I feel a little better. My Dr says nothing to worry and does not feel I should go for any further tests again. He is telling me it is due to the stresses am going through. Am under antacid and a pain killer for another 5 days. My question here is do I need another ECG tests or the CT scan result (taken a month ago) is good enough to depend on for the status of my heart. Help!!
Tina, Pokhara, Nepal, November 2, 2011

• I had the Nuclear perfusion test two years ago at age 66. It showed a 20% blockage. How often should I have a retest?
Joe in Saratoga, Saratoga, California, USA, October 22, 2011

• MY SON IS 22 & HAS BEEN HAVING HIGH BPs AND & PULSE RATES. I STARTED TAKING HIS BP & HR 'CAUSE ONE NIGHT HE WAS HAVING SEVERE PAIN IN UPPER ARMS WITH RAPID PULSE. HE DOESN'T HAVE INSURANCE SO IT TOOK SOME CONVINCING TO GET HI TO DR. OF COURSE HIS BP & PULSE WAS OK IN OFFC. BECAUSE HE IS OVER 18, I CAN'T GET ANY INFO FROM THE DR OFFC AND MY SON SAID HE DIDN'T UNDERSTAND ANYTHING THE DR WAS TELLING HIM. DR HAS REFERRED HIM TO A CARDIOLOGIST 'CAUSE OF SOMETHING IN HIS LAB WORK. BELIEVE ME, I WILL GO TO THE NEXT ONE. WHAT WOULD BE IN THE LAB WORK THAT WOULD HAVE HIM REFERRED TO CARDIOLOGIST?
RAE, South Carolina, USA, October 4, 2011

• I am having a Nuclear drug stress test no exercise part this week for 2 days in a row. I am scared about it. Is there any reason I should be scared about it? 2 of my valves in my heart are not working right. I am 63 yrs old woman.
Scared having a nuclear pharmaceutical stress test this week, Vernon, Connecticut, USA, August 9, 2011

• I am a 53 year old male nonsmoker, rarely drink, eat well, and exercise 3-4 times/week. Two years ago I had a nuclear stress test and echocardiogram because of chest pain suffered during and after tennis matches. Cardiologist did not find any blockage. Was told to take a baby aspirin daily. No more problems. Three months ago I stopped taking aspirin because I had a colonoscopy coming up in a month. Had the colonoscopy on a Monday. The next day after a tennis match I had a heart attack. RCA was completely blocked and LDA was 85% blocked. Now have a stent in my RCA and LDA. Also on big aspirin, Plavix, metoprolol, and Simvastatin. I now have a different cardiologist. How is it possible that two years ago they did not detect significant blockage?
DSW, Ft. Myers, Florida, USA, August 8, 2011

• My dad was 80 years old. He had 1 stent put in 1 year ago. .His wanted him to have a Nuclear stress test,"to make sure everything was ok." Keep in mind, he had no symptoms, etc. After the stress test, he had rapid heart rate, tachycardia, had to be admitted to the hospital. He acquired pneumonia 1 month later and died. I blame his doctor for this, shame on him for sending an 80 year old for a test that is a money sucking test!I have no faith in the medical field.
lynn, Albuquerque, New Mexico, USA, May 12, 2011

• youngandscared in Illinois and Rebecca in Arkansas -- read more about Nuclear Stress Tests in our "Patient Guide to Heart Tests". Specific information on Nuclear tests can be found here. When you get a stress test, nuclear or otherwise, you are hooked up to an EKG and the cardiologist or nurse watches your heart rhythms, stopping the test if the EKG becomes abnormal, or when you've reached the proper heart rate and they have their data. Rebecca -- you were given Lopressor, which is a beta-blocker, to slow down and stabilize your rapid heart rate. Definitely communicate your concerns to your cardiologist. The reason he/she is giving you the NST is to try and diagnose your problem. The "meds" are low level radioactive isoptopes which will trace the flow of oxygen. Youngandscared -- the radiation exposure in a nuclear stress test is around 13-15 mSv. We typically absorb about 5mSv a year just walking around, so you're not going to get cancer from a single test. The concern in medical circles is the repeated exposure from multiple tests that use ionizing radiation (nuclear stress tests, CT scans, angiograms, etc.) and in clarifying under what circumstances these tests are necessary.
Angioplasty.Org Staff, Angioplasty.Org, May 6, 2011

• I am 18 years old and just had a baby, during my 3rd term, i started having rapid heartbeat and they put me on Lopressor and now my heart has been hurting really bad lately, The cardiologist wants to do a Nuclear NST and give me some meds to get all the meds out of my system and then see what happens and then give me meds to make my heart race really fast and make me go on a treadmill, I'm scared that i will like have a heart attack or something or something bad will happen, is there any severe side effects of this?
Rebecca, Fort Smith, Arkansas, USA, May 5, 2011

• In Oct. 2008 I was admitted to the emergency room after having some chest heaviness, not really any chest pain. Anyway blood tests were ran and it cam back positive for troponin levels. I was transported to a different hospital where, after two more troponin level tests were conducted and came back negative, I was observed for 24 hrs and released. Long story short I was referred by my doctor to a cardiologist. After already passing a stress test and echo cardiogram he had me take a Nuclear Stress Test in 2010. I passed that with flying colors as well. He even stated that he believed that my first troponin test was most likely a false positive. My question is this, I have since read a lot of articles and I am concerned over the radiation I was exposed to during this test. I refuse to take another one. I was 39 when I took the Nuclear Stress Test. Do I now have to worry about getting cancer? Do I still have a chance at living a long life without getting cancer or am I now doomed to sometime get it in the future at a younger age than I should have because of this test? Are there a lot of people who get cancer within years of taking this test? Please help with some info.
youngandscared, Maryville, Illinois, USA, May 5, 2011

• AlanB -- We couldn't say. Did you ask this question of your cardiologist? Sounds like you're doing fine. It would be nice, of course, to get some validation and encouragement.
Angioplasty.Org Staff, Angioplasty.Org, April 27, 2011

• What does it mean if my Cardiologist wants to see me in six months? I had a STEMI and one stent placed 8 months prior to this stress test. Does it mean I am doing really well?
AlanB, Oak Park, Illinois, USA, April 27, 2011

• Dad's Daughter from Kentucky -- Your dad (with perhaps another family member) should see his cardiologist, or the doctor that ordered his nuclear stress test, in order to get a clear reading and an answer to your question about "what happened to the 69% blockage". We are assuming that the earlier test from four years ago was a cath, because it's not possible to assign a percent blockage using a stress test. Actually, there's much thought now that even an angio can be inaccurate. A recent analysis of the FAME study showed that only 1 out of 3 blockages measured by angiography in the 50-70% range was actually causing ischemia. And even nuclear stress tests can be inaccurate, although if this recent one showed no ischemia, that's not a bad thing. One other way to see if there's a significant blockage is a Cardiac CT angiogram. This is non-invasive and takes a few minutes. Although there is some exposure to radiation, it's not as much as with a nuclear stress test, if the facility doing the CT is using low-dose protocols. The only other test is, as you say, another cath -- and that's an invasive test, not indicated for a patient who has no symptoms or other abnormalities. Discuss these questions with your dad's doctor and go with him to the appointment AND ask as many questions as your family needs to be assured of his state of health. And read our article, "You and Your Physician."
Angioplasty.Org Staff, Angioplasty.Org, April 23, 2011

• I would like to know if further tests are needed for my dad Please help if possible he is a stubborn man age 64. Four Years ago he had a stress test or cath and they found a 69% Blockage the Dr's told him and my mom nothing needs to be done until the blockage is 72%. My dad is on Atenolol Beta Blocker 50mg also he takes a baby Aspirin and carries Nitro in his pocket. He is a little fellow approx 130, 5'7-5'8 that works very hard, very hyper until here lately he gets out of breath easy face turns really red and he is sleeping a lot which is not his character at all. On April 21,2011 he had a NST done after tread mill his BP was 125/100 I thought odd maybe it was the Nuc meds. But the next day a really rude dr called and said Mrs your test was 100% A OK and before my mom could say anything (such as she was not the patient HIPPA) he hung up. unable to get answers until Monday My main question is if My dad is 100% ok what happened to the 69% blockage did it disappear? Or should my dad be convinced to get another Cath done? Its too late when he is gone and neither my mother or I are prepared for that. Please help with advice
Dad's Daughter of 35 years, Very Concerned Daughter, Georgetown, Kentucky, USA, April 23, 2011

• Stent athelete -- Your doctor is correct about the radiation cumulative dose. A nuclear stress test can actually expose the patient to more ionizing radiation than a full dose Cardiac CT Angiogram (CTA) -- speaking of which, even with current low dose protocols, a CTA is not recommended as a periodic "check" either, for exactly the same reason. BTW, have you seen the announcement about the October Medtronic Global Heroes marathon? You might be interested in running that.
Angioplasty.Org Staff, Angioplasty.Org, March 14, 2011

• Forum Ed- Test being recommended is echo exercise stress test (non-nuclear as doc concerned about cumulative radiation dose over hopefully long lifetime). Might also mention I am NOT diabetic and ran 10k lst week with no symptoms (in 49 min to HR 174 on good HR monitor). Question really is how often to stress test VERY active cardiac stent patient with no symptoms. I would gladly pay for periodic CTA if it were proven useful in patients with stents.
Stent athlete, Indianapolis, Indiana, USA, March 11, 2011

• I had a nuclear stress test and they checked my arteries for blockage. I was told the tests came back as normal. The one thing they have come back and said is that I have what is called left bundle branch block. 2 years ago I had a stress test (treadmill) and coronary artery check, and I passed both of those tests. There was no indication of left bundle branch block 2 years ago so what has happened since then to cause this? I am having a electro cardiogram done next week.
Sandra V., Elberta, Alabama, USA, March 4, 2011

• Stent athelete -- first off, congratulations on returning to a full and active life! You might want to check out our Forum Topic on Exercise, etc. After Stenting. There are quite a few runners, etc. there. Just a quick question: is the stress test being recommended a nuclear test, or just a standard echo stress test?
Angioplasty.Org Staff, Angioplasty.Org, February 25, 2011

• Received Taxus stenting of my Left Anterior Descending artery 4 yrs ago (age 49), & told remaining coronaries clean then. Had normal nuc med stress test (to 176 HR) 2yrs ago. I am VERY active now with no symptoms (triathlon, marathon last Fall, now running 25+mi/wk). ECG normal, but family doc wants "monitoring" stress echo every year or 2. Anyone know of data supporting such periodic stress testing in active active adults with coronary stent?
Stent athlete, Indianapolis, Indiana, USA, February 25, 2011

• Both my husband I have had stress test issues recently (12/2010). I walked out after half of one of those nuclear/stress combo tortures ... literally ... people chasing me with paperwork to sign. My husband had one doctor insist he needed one; another did not recommend (long story). How do you trust anybody in the medical field / pharmaceutical industry these days? (Apologies to all you hard-working physicians who wouldn't dream of prescribing unnecessary tests or meds.) But I am finding it more and more difficult to have faith in the system....
Shellydee, Baltimore, Maryland and Central Florida, USA, December 26, 2010

• Good questions. Statistics show that 37% of patients getting catheterizations (angiograms) show no significant coronary artery disease. Many of these patients get this test because a nuclear stress test showed a possible blockage (ischemia or under-oxygenated heart muscle in a specific area). It's conceivable that reduced lung function might also be a cause of under-oxygenated blood. This is one reason that there is some debate in the medical field about the use of CT angiograms as an alternative to the nuclear stress exam. This test is non-invasive and take minutes -- and the results show a picture of the coronary arteries and are very accurate if there is no blockage. Of course, if a significant blockage is seen, an angiogram would still be needed to verify the amount of blockage. Read more in our "Patient's Guide to Heart Tests".
Angioplasty.Org Staff, Angioplasty.Org, December 4, 2010

• I had a ekg, it showed slight irregularities. The cardiologist said it could possibly be from the water pill for high blood pressure. He ordered a sonogram which came out perfect. He also ordered a nuclear stress test that showed blockage. I'm scheduled for an angiogram. He said it could be from a blocked artery, lung problems, or acid reflux. How can a sonogram come back perfect, but the nuclear test show blockage. How can the lung cause a blockage and how can acid reflux show a blockage.
Snookers, West Union, Ohio, USA, December 3, 2010

Maurice -- I cant believe the costs in USA. In Portugal (ALgarve region)I had a nuclear stress test done for 500euros and that was done by the Cardiologist himself, and done in a private hospital down there. It would be cheaper and better to fly to Lisbon, take the high speed bullet train ( 50euros return) at 200 mph, have a holiday in the sun, have a stress test, and return to USA.
tel, UK, November 27, 2010

• Steb from Australia -- what did your cardiologist say? It may be that you have a non-cardiac condition that is causing this.
Angioplasty.Org Staff, Angioplasty.Org, November 27, 2010

• I was prescribed an exercise stress test after some chest tingling and a 37 y.o brother that just recently died from unknown causes. After 13 minutes on the treadmill the test was stopped. I was a bit surprised as I didn't think my heart was being stressed at all--about an intensity of 3 out of 10 if I had to rate it compared to high-intensity exercising I sometimes do. I had no problem carrying on a conversation during the test, nor was I breathing hardly any harder than normal straight after the test. So I was very surprised when the (-ve) results came back saying the reasons for stopping the test was dyspnea. Does all this sound right to you?
Steb, Sydney, Australia, November 25, 2010

• Franki -- there is a lot of concern about the overuse of CT scans, and a nuclear stress test actually has a higher radiation dose than a CT angiogram of the heart. Are you having symptoms? The echo you had can show thickening of the heart wall and the condition of your valves. A nuclear test would help diagnose ischemia -- when there might be a coronary narrowing that prevents enough blood/oxygen from reaching the heart muscle. But without symptoms, not sure what the reason would be. Ask him/her.
Angioplasty.Org Staff, Angioplasty.Org, November 20, 2010

• I recently saw my cardiology physician who checked me out . and said the only thing he could see was a slight thickening of the heart muscle which was not anything serious. i had a nuclear stress test a year ago, and now is recommending another. Is the $4000 of which he can add to his retirement fund really necessary? feel like i should cancel it. also had an electro cardiogram, and another echo gram coming. i read that nuclear stress tests should not be given every year.
Franki, Sunrise, Florida, USA, November 9, 2010

• I am a man of 60yrs old & suffered a MI in February 2010. I had a Stress Echo 6 months ago, it was carried out at Guys hospital in London. because of my disabilities I couldn't use any exercise equipment so i had to go into a MRI scanner. I was told all what was about to happen when they will start the procedure & after half way (about an hour) they will start injecting a drug called Dolphamine which will cause the heart to race (like running a marathon i was told) the doctor said that it could cause chest pains, shortness of breath, in fact all the symptoms of a heart attack & could even have an heart attack, that is why there are always 2 cardiac doctors there when they carry out this test. The radiographer told me when he was injecting the drug,I suppose I was lucky because i never felt any discomfort at all.The worst part was being in the scanner for over 2hours without coming out of the tunnel.Not a good experience but i was assured that it was necessary to get the correct results. I was pleased when it was over & done with for sure.But the reason why it had to be done made me overcome the fear of the long session in the Tunnel. the results were good thankfully & I had a stent
Mick, Sittingbourne, Kent, UK, November 6, 2010

• Hi, I am a Canadian male, 56 had a heart attack in February 2010 and inserted LAD bare stent (Liberte x 20mm). There were another 2 blockages in mid RCA then inserted a long Xience x 38mm after 10 days. I am on Plavix, Coversyl, Lopressor SR, Crestor and Asaphen. I had an echo-cardiogram done after 3 months and it said my heart was 50% improved. Now I am outside Canada for 1 year for an assignment. I found a cardiologist here and he asked me to do another echo-cardiogram and stress test to assess my heart. Could someone tell me the best time to do stress test after angioplasty please? Thank you.
Tom, Quebec, Canada, September 6, 2010

• Josee from Georgia -- the nuclear exam shows whether the heart is getting enough oxygen and your cardiologist probably wants to check that the stents are actually doing their job. An angiogram doesn't show this information.
Angioplasty.Org Staff, Angioplasty.Org, September 4, 2010

• My husband recently had 2 stents put in. His cardiologist wants a Nuclear Stress test performed in 3 months. Since he just had a heart catheterization done. Is this test really necessary? The blockage has already been diagnosed and 2 stents were placed. What can this test actually show that a heart catheterization can not?
Josee, Georgia, USA, August 28, 2010

• I have a question how soon is it safe to have a stress test after a STEMI which was treated with PCI with DES placement? (my appointment is booked for 4 weeks post-event) Also,if the test is being done in order to come up with a safe maximum exercise heart rate for a cardiac rehab exercise program and is a prerequisite for the program, is it best to stay on your beta blocker for the test, since you will be taking it daily when you are exercising in the rehab program. I have had mixed messages about taking beta blocker or no and won't be seeing cardiologist before the test. thanks.
Dave B., Burnaby, Canada, August 21, 2010

• Tillo from Florida -- we've seen costs somewhere in the area of $500 for a CTA. Where did you get such a figure. That's more than a catheterization costs.
Angioplasty.Org Staff, Angioplasty.Org, August 21, 2010

• Editor -- just a point, You obviously favour the new multi slice 64 heart scan and so I but perhaps u could tell people what they cost my local hospital want $10,000 for such a test. It will never happen until it becomes viable!
Tillo, Davenport, Florida, USA, August 21, 2010

• So many stress tests are unnecessary, but it is a great way for cardiologists to earn anywhere from $400,000 to $1 million a year. This explains why according to UN studies, the USA is ranked 37th in healthcare and number 1 in costs per patient. It's disgusting. It's also the single most important reason why I supported President Obama's healthcare legislation. It will reduce repetitive testing, and hold physicians more accountable for these tests,so many of which are unnecessary.
Maurice, San Francisco, California, USA, July 9, 2010

• Julia -- stress echocardiograms are excellent diagnostic tools to view the action of the heart valves -- we assume that the results will shows if your aortic valve is working correctly.
Angioplasty.Org Staff, Angioplasty.Org, date, 2010

• What are some important questions I should ask my cardio next week? 42 year old female had aortic root enlargement and replacement 9 years ago. I had a breathing test, rest echo, chest X-ray, thyroid test, magnesium test, holter monitor test. He said is wasn't time to replace the tissue valve yet and ordered a stress echo. all tests to this point were good. I have migraines, nausea, shortness of breath during activity, benign palpitations, fatigue, my legs and arms ache and feel like they go to sleep with activity. During the stress echo they pushed me as far as I could humanly possibly go, with a 200 bpm 7 minute workout. I didn't pass out but was on the verge. They wouldn't tell me the results on Friday afternoon as the cardio has to read it. What will the stress echo show and what questions should I ask when I get my results, does it sound like standard procedure? If everything comes back fine here then what. I know what I felt like before replacement do I just chalk it up to being out of shape and resume everyday life feeling miserable, if this is normal I will but don't want to keep paying for unnecessary tests. Thank you.
Julia, Denver, Colorado, USA, June 20, 2010

• Performing a CT angiogram as an alternative to stress tests has been studied and the CTA has scored pretty well. It's non-invasive and can be done with low-dose radiation protocols. Cardiologists who have worked with CTA feel strongly that it should be the preferred test (read the interviews with various experts in our "Imaging and Diagnosis Center". The negative predictability of CTA is very high, so if the CTA shows no coronary disease, there isn't any.
Angioplasty.Org Staff, Angioplasty.Org, June 4, 2010

• I'm a 67-year-old female. For about four months I have had a mostly mild ache in the left breast area which is accompanied by mild ache directly back to the left shoulder blade and left arm. The discomfort comes and goes but is usually present, and usually at only a mild level. Exertion seems to increase it somewhat, but not dramatically. I had an echo cardiogram and nuclear stress test and both were normal. I'm on low-dose aspirin and pravastatin for cholesterol. The ache continues. The cardiologist I saw put me on omeprozol for acid reflux a couple of months ago, but it hasn't helped. He suggested doing an angiogram, but I don't want to be an alarmist and pursue medical testing when it's not strongly indicated. I have three brothers with heart conditions (by-pass surgery, stent, and angioplasty). Does my situation sound familiar to anyone. I am generally healthy, exercise regularly, and not inclined to frequent "doctoring".
Kay P, Arizona, USA, May 21, 2010

• My Mom is almost 90 and her doctor wants her to do a stress test, of course w/walker or something to hold onto. She was diagnosed w/Angina. I do not feel it's necessary or safe, as I have heard stress tests can bring on a heart attack. A heart doctor who operated on my Uncle about 8 years ago told me that. Thanks.
Debi, Florida, USA, May 20, 2010

• Adam -- read the related topics in the right hand column for more info on what these tests show. False positives are not uncommon in stress tests. Some cardiologists feel that CT Angiograms are more accurate for ruling out blockages in the coronary arteries.
Angioplasty.Org Staff, Angioplasty.Org, May 14, 2010

• i had a stress test 3 wks ago which showed that i might have blockage in my artery. My dr suggested having a nuclear stress test to be sure. He did mention it could be a false positive. I had the nuclear, and it came back perfectly normal. Why would the first test show something the notes said possibly a 2mm blockage.
Adam, Long Island, New York, USA, May 12, 2010

• I had five stents put in last September after a nuclear stress test showed problems. My doctor has now ordered a stress test for me but the insurance company denied it saying it could be done every two years. Am I in trouble?
Margaret M., Brooklyn, New York, USA, September 18, 2009

• Suzanne -- Has your cardiologist suggested getting a CT Angiogram to see if in fact you have any blockages? It's non-invasive, although it uses IV contrast dye and only take a few minutes. If you do, make sure the provider uses the most current low-dose protocols to minimize radiation.
Angioplasty.Org Staff, Angioplasty.Org, September 16, 2009

• Could someone please tell me the significance of "Ischemia is seen at the apex." I had an MPI study with adenosine (I could not do the treadmill because of severe pain associated with a GYN problem, which has since been resolved with surgery). The only other abnormality mentioned on the test was a "small, mild perfusion defect at the apex that re-perfuses with rest." NO ekg changes were seen (and that includes ST depression which often means ischemia). I am on Lipitor 40 mg/day, ASA 81mg and metoprolol 25mg (my HR usually ranges from 46-54 daily).The doc wants me to be cathed. I do not want to go to cath lab because I do not want angioplasty, not the least reason is because I am allergic to metals. Can't wear jewelry, even earrings with surgical stainless bother me. I have been reading the posts about a stenosis may be >70% but unless it its flow-limiting (does this mean ischemia????) it may not need to be addressed. The reason I had the nuclear perfusion study: My GP referred me to cardiology because of a coronary calcium score of 285. I was already on Lipitor 10mg which brought my TC down from 262 to 179; brought LDL from 175 to 104. TG was always low at 63. PLEASE help!
Suzanne A., Norman, Oklahoma, USA, September 12, 2009

• i had a stress test last month and my heart rate didn't slow down fast enough and the doctor just blew it off with no further testing. i'm 36 year old male,252 lbs i'm tired all the time i get sick when i go outside for more than an hour so.and days i can't get out of bed till 10 or 11 o'clock. and fill sick all day.the doctor put me on blood pressure meds.and i felt and like death him self with black rings under my eyes so he raised the amount i was taking and i got worse.when i started the meds my bp was 140/80 which is normal. I quit take all meds. any ideas.
Jason Foster, Galena, Missouri, USA, June 17, 2009

• I had a stress test done about a month ago indicating a probable blockage. It was nuclear [well I did walk on a treadmill, they injected some stuff and made me sit real still on a machine that rotated around me] they did this both at rest and after excercise. Anyway as a result I was followed up with a cardiac cath that came up clean. Something the FIRST doctor did not mention that women with ample breasts can have about a 20% false positive rate because of interference with the signal through the breast fat - it would have been nice to have been told about this up front and I would not have been as freaked out as I was.
Nancy, South Carolina, USA, May 23, 2009

• Kevin -- a nuclear stress test is normally given if the patient is symptomatic (angina, etc.) and the cardiologist wants to see if there is ischemia. An exercise stress test can tell some things, but doesn't really give much information about coronary artery disease. Other non-invasive tests to find out about CAD are a Cardiac CT Angiogram, or even a simple Calcium Score, a low radiation CT look at the calcium in your arteries. Note that while much has been published in the popular press about the radiation doses from Cardiac CT, a nuclear stress test exposes the patient to as much if not more radiation than a Cardiac CT Angiogram.
Angioplasty.Org Staff, Angioplasty.Org, May 20, 2009

• I just fired my cardiologist for attempting to pad the office bill by adding an unnecessary nuclear (adenosine) stress test. I didn't go along with it. According to the American Society of Nuclear Cardiology an exercise stress test is indicated for me since I am in good health, I'm 54 years old, I exercise quite often (walk 20+ miles/month), I have no recurring angina since my ischemic attack and subsequent stent emplacement in 2006, I have no exercise restrictions, and I am not disabled, feeble, or have trouble following directions or walking or even running briskly for 20 or 30 minutes. The difference: An exercise stress test costs $250 of which I pay all with deductible. The nuclear stress test costs $4000 of which I pay $1000 with deductible. Since it's a huge cardiac practice, they do all their own tests on-site. I can only surmise that she wanted to pad my bill. I gave her the heave-ho and am now managed by a GP who will refer me to a cardiologist when she feels it is necessary.
Kevin, Albuquerque, New Mexico, USA, May 18, 2009

• CA -- while it's hard to understand how a nuclear stress test would not show any ischemia in a patient with 85-95% blockages in four arteries, it is an example of why many of the imaging specialists interviewed in our Imaging and Diagnosis Center believe that Cardiac CT Angiography (CCTA) should be the primary test for coronary artery disease.
Angioplasty.Org Staff, Angioplasty.Org, May 17, 2009

• Hi, On April 22, I had a nuclear stress test and blood work...well 8000.00 worth and got the green light! My heart was in perfect shape..On the 25th I had a major heart attack in the ladies restroom at a roping. I died and then came back..Needless to say, I had 85-95% blockage in 4 arteries. I am home now, my Dr. put 5 stents in, but I am having chest pains quite often and a little shortness of breath. I take the nitro and get some relief but I don't know how many times a day I can take it? For every episode? Are these chest pains normal? I am trying hard not to be afraid!! Anyone have any answers?
CA, Monahans, Texas, USA, May 17, 2009

• I had a stress test done. The Dr. said I have all the criteria for a blockage but he could not see one. I had a positive d-dimer, and the velocity measured in my right Artery was very high, and it was also not right in my legs. The dr. explained it was like putting his thumb over the end of a water hose and it increasing the pressure. He advised me to lose weight and relax more.... but everything else was ok... my sugar, cholesterol, salt intake. He said he kind of was looking for some of that to be "off" so that he could say that maybe it was some of the problem, but it wasn't. Should i also have my head checked for blockages, could it be there? Should I get a second opinion?
Sherrie Wisdom, McKenzie, Tennessee, USA, April 28, 2009

• On 8-15-08 I had every symptom for a heart attack known. I being the "It's not happening person" did not go to the Hospital. I did call my Dr. and he ordered a Thallium Stress test. I just got the results by phone and was told everything looked normal. Does anyone know, is it possible to have a heart attack and it not show up on this test? You couldn't order more perfect symptoms of a heart attack that I experienced. If anyone can help, please advise.
Tim, Ohio, USA, August 26, 2008

• Jeanne -- a nuclear stress test is done to see if the heart is getting enough oxygen/blood. There is radiation associated with the test, about 15 millsieverts, so it's not a test you'd want to get annually, unless there's a compelling reason. You are diabetic and have already had a stent placed. Published guidelines find it reasonable to be tested two or more years after a normal result. One question for your cardiologist is that the imaging/testing pathway is undergoing revision and some cardiologists feel that Cardiac CT Angiograms can be done with less radiation, and are more accurate for excluding coronary artery disease.
Angioplasty.Org Staff, Angioplasty.Org, June 26, 2008

• I had a heart attack 3 years ago and had a stent inserted. After 2 years the doctor took me off Plavix, but I am still taking 81mg aspirin daily, among other meds for Type 2 diabetes, blood pressure and osteoporosis. I am active and feeling fine. Is it recommended (or necessary) that I take a nuclear stress test annually?
Jeanne, Florida, USA, June 22, 2008

• I had a thallium stress test in February 2006 after nearly 2 weeks of mild to severe chest pain while walking. I was sure it wouldn't reveal anything significant but the nurse stopped the stress test early, put me on oxygen and said my ECG was abnormal. Even though the thallium test prior to the stress test was normal the nuclear test afterward showed major blockage - 90% in the LAD and 70% in the left circumflex. I checked into the hospital that night and experienced intense chest pain while at rest. When I had the angioplasty, the cardiologist said the LAD was actually 100% blocked and the left circumflex was 90% blocked. He also found and removed a blood clot and said that I had good collateral circulation from my RCA which is what prevented me from having a heart attack. I'm convinced the nuclear stress test saved my life. If I had not had it, I'm sure I would have suffered a fatal heart attack.
Albert S., Illinois, USA, February 25, 2008

• I would have to agree, with stress test, being a waste of money and time. I was sent for a stress test because I was complaining of chest pain, and finding it hard to breathe at times, now the magic of this is, AT TIMES. The stress test showed there was nothing wrong with me, everything was normal, or as normal as could be after going through an MI, so home I go, everyone thinking the problem has been cured, I am on my way to recovery when BAM I have a major MI, my stent was closing over on one end, and had closed causing a MI. But hours prior to that I was fine and the stress test proved that, sometimes I wonder, That stress test proved to my boss that I was fine and should have been at work, but I wasn't and I got fired, sooooo, when a stress test is mentioned to me I just laugh, and say no thanks.
Patsy Wellwood, Nova Scotia, Canada, February 15, 2008

• Dr. R. -- your observation is correct that stress tests, including nuclear stress tests, are not as accurate in diagnosing CAD as other tests -- and this seems especially true in women. They are, however, important in determining whether there is a functional deficit (not enough blood getting to the heart muscle). CT Angiography (CTA) is much more accurate in ruling out CAD (99+% in all current trials) -- somewhat less so in positive results. A number of imaging specialists we've spoken with think that CTA will replace many of the thallium stress tests -- although if CMS decides to cut back CTA reimbursement, this won't happen as quickly.
Angioplasty.Org Staff, Angioplasty.Org, February 14, 2008

• Since there was no question in your post I am addressing a different aspect of the topic you bring up and then invite the editors to comment. I am a physician whose mother at age 75 had an MI 6 months after a negative stress test. This caused me to research the literature. From my research I have concluded, in my OPINION, stress tests are among the biggest scams in mainstream US medicine. First, pretty much all of the research I found was done on 55 year old males. Secondly, they are about 75% accurate in predicting CAD. Sounds good. But this means if you do 1,000,000 in a year you will have 150,000 MISSED cases of CAD. Not very good. Could the money spent on stress tests be better spent in our very wasteful US healthcare system (I also have a management masters degree)? I believe so. What do the editors think? Have I misinterpreted the data?
Dr. R., Pennsylvania, USA, February 14, 2008

• I just had a thallium stress test. My pulse was in the low forties and would go to the low fifties and return to the 40's. The medication caused me chest and neck pain and the stress test could not be finished. Diagnosis: ischemia.
Anna L., Wyoming, USA, January 26, 2008

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