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Nuclear Stress Test vs. Cardiac Catheter
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jeffreyse posted:
I was hospitalized for having chest tightness (not really pain) and short of breath. They did an echocardiogram and the results came back that there was a problem with the heart not completely filling up with blood between beats. (Sorry, I don't have the report handy and can't remember the medical term for it). I saw my cardiologist 2 weeks ago. He did an ekg and said it was abnormal. He then sent me to have a cardiac catheter done. It came back with just a 30% blockage and I was sent home.

I am still experiencing the same symptoms and I went to a different cardiologist today, just to see what he would say. He also did an ekg, said it was abnormal, and he didn't even know why they still do them because he said it is 20th century medicine and means basically nothing. So he told me not to worry about it. After he said that, I was skeptical about anything else that he said. My primary care doctor had written a script to do a nuclear stress test to check the function of my heart, but he said there was no way I needed that since they already did the cath. He also told me that the report from my echocardiogram, that showed the problem, meant nothing, and that almost everyone who has the test done comes back saying the same thing. (So apparently, according the the doctor, ekgs mean nothing, and nobody's heart fills up between beats). I think I must have been bothering the guy because he basically showed me the door at that point. I won't be returning to his office.

Could the nuclear stress test show something that the cath. doesn't about my heart function? I'm more worried about the function of the valves and heart in general under stress. Especially with 2 abnormal ekgs and the abnormal echo.

Any advice is appreciated. Thanks.

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cardiostarusa1 responded:
Hi:

"A problem with the heart not completely filling up with blood between beats."

Sounds like diastolic dysfunction.

"Cardiac catheter done."

Well at least a heart cath is the "current gold" standard for imaging blockages in the coronary arteries.

"Just a 30% blockage"

As reported, the symptoms of artery-narrowing atherosclerosis are highly variable. Those with mild atherosclerosis may present with clinically important symptoms and signs of disease and heart attack, or absolute worst case scenario, sudden cardiac death (SCD) may be the first and only symptom of coronary artery disease (CAD). However, many individuals with anatomically advanced disease may have no symptoms and experience no functional impairment.

"Could the nuclear stress test show something that the cath doesn't about my heart function?"

Keep in mind that each diagnostic imaging modailty has its strengths and weaknesses, limitations.

Just as examples, gated-SPECT scan with higher-energy lower radiation technetium-based radioisotopes Cardiolite or Myoview, synced to an ECG/EKG, which provides information about left ventricular ejection fraction (LVEF, the single-most useful indicator of how well the heart is pumping), regional and global wall motion (kinesis) and thickening, as well as end-systolic and end-diastolic blood volume.

Heart cath can't see (nor can nuclear imaging) vulnerable plaque, the cause of the majority of heart attacks (by way of rupturing and causing a blood clot).

HeartSite

Isotope/Nuclear Stress Test

See: Actual rest/stress nuclear images

The physician can separate a normal left ventricle, from.....

http://www.heartsite.com/html/isotope_stress.html

Coronary artery anatomy

Starting with he LAD

http://www.heartsite.com/html/lad.html

HeartSite

Cardiac Cath

What is the reliability of the test? How

http://www.heartsite.com/html/cardiac_cath.html

Mayo Clinic

Coronary angiography: A look inside your heart's blood vessels

http://www.mayoclinic.com/health/coronary-angiogram/MY00541

ALWAYS be proactive in you healh care and treatment. Sometmes this requires being assertive. Most important, communicate/interact well with your doctors.

Best of luck down the road of life.

Take care,

CardioStar*

WebMD member (since 8/99)

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Good to know for the primary and secondary prevention of heart attack/brain attack


Epidemiologic studies have revealed risk factors for atherosclerosis, e.g., age, gender, genetics, diabetes, smoking, inactivity, obesity, hypertension, high LDL, high Lp(a), high ApoB, high Lp-PLA2, high triglycerides, LOW HDL (less than 40 mg/dL, an HDL level of 60/65 mg/dL or more is considered protective against coronary artery disease), high homocysteine, high C-reactive protein (CRP/hs-CRP), etc

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Heart-Healthy Foods

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WebMD

Heart Disease TYPES

Men/Women

Acquired/Congenital

http://www.webmd.com/heart-disease/heart-disease-men

SYMPTOMS

http://www.webmd.com/heart-disease/guide/heart-disease-symptoms

Mayo Clinic

Heart Disease

Definition. Symptoms. Causes. Risk factors. Complications. Tests and diagnosis. Treatments and drugs. Prevention...

Heart disease is a broad term used to describe a range of diseases that affect your heart, and in some cases, your....

http://www.mayoclinic.com/health/heart-disease/DS01120


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