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Stress Tests
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Current Postings on This Page (102):
• Hi i am sorry I am confused how much mSv did I recieve for my 2 day stress tests with the technitium 99 myoview ? I am sorry but the answer confused me it said "the dose is lower than i am calculating" at the end of the response. Is what I revieved hgh enough to be concernd with future cancers? thank you Also i was only 30 years old female thanks. Also PLEASE clear up what i copied from the conversion chart is 27 mCi equal to 10 msV or 100 msv?? Please look at the link of what i posted what is that conversion chart about?? WHAT is the differenve between m Ci ad mCI on my report it says mCi with no space so how much mSv is that? please explain? thanks
• Hi Please help me to understand. I found this radiation conversion chart https://people.uwec.edu/jolhm/EH/Rosenhoeft/index5.htm. I am seeing that 27 mCi can equal 100 mSv (above) then it says 27 m Ci =10 mSv (above) I had technetium 99 injected into me in 2 doses 2 days apart: one was 31 mCi for rest and stress and 30 mCi. for cardiac stress test. I was young about 29 years old at time of test; female of normal weight. It was for anxiety related chest pain and test was normal. This was 12 years ago approx. The doctor office is now closed where the procedure was done and he passed away. I have no one to ask how much radiation was I exposed to? How many mSv? Looking above chart it can be a lot! Either way I think I did get a high dose? I am concerned with long term effects please help me to understand how much radiation and what long term effects could be? I am nervous and really would appreciate a response to help me understand. I am currently "watching" a highly suspected nodule thyroid and wondering if could be related.... I know you can't tell me for sure, but please tell me what you can about the 2 doses I received 2 days apart. Thank you
• have been suffering from severe shortness of breath on exersion, chest pain, dizziness, all my blood work comes back normal. my Stress echocardiogram showed that a portion of my heart muscle was not getting enough but was told it was inconclusive. I have been put on baby aspirin and nitro. symptoms getting worse. don't know what to think. • I started having weird symptoms about 4 months ago. I workout 6 days a week and eat pretty healthy. I suddenly felt tense in my neck and got anxiety about going anywhere or doing anything. I went to a neurologist because i was convinced i was having an anuresm or tumor.i also have went to cardiologist wirh chest preasure and breathless. Ears ringing too. Had ekg normal echo normal and ekg stress test was normal. Chest x-ray and d-dimer normal. Ent said tmj. I waz reading google and many women have blockages and are young and haf normal tests.my blood pressure is low normal heart rate cholesterol normal. After 3 mri and mra everyrhing was normal. • 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! • 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. • 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.
• 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.
• 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?
• 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. • 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. • 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!!!! • What drugs should I stop before a nuclear stress test? I take Plavix, atenenol, imdur??? • 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. • 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 • 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. • 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!! • 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.
• 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?
• 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?
• 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.
• 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.
• 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 • 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. • 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.
• 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.
• 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?
• 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.
• 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. • 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. • 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!! • I had the Nuclear perfusion test two years ago at age 66. It showed a 20% blockage. How often should I have a retest? • 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? • 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. • 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? • 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. • 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. • 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? • 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. • 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. • 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? • 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." • 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 • 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. • 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. • 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. • 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? • 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? • 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.... • 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". • 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. • 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. 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? 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. • 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 • 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. • 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. • 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? • 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. 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! • 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. • 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. • 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. • 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. • 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". • 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. • 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. • 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. • 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? • 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. • 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! • 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. • 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. • 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. • 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. • 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. • 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? • 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? • 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. • 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. • 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? • 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. • 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. • 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. • 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? • 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. |
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