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Current Postings on This Page (14):
• 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.
Forum Editor, 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.
Forum Editor, 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.
Forum Editor, 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.
Forum Editor, 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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