Question Title: need for cardiolite stress test

I am a 50 y/o w male who had an MI 8 YEARS AGO, documented by ekg and enzyme changes. At that time, coronary arteriogram revealed no blockage, and it was concluded that the myocardial insult was brought on by vascular spasm secondary to stress (the presence of drug induced spasm was ruled out by both history and drug testing).I was fortunately able to change professions and reduce the stress in my life considerably. Nine months ago,I had a thallium stress test which showed "probable ischemia" under the conditions of the stress test and I was advised to undergo another angiogram. As 8 years ago, the test showed no blockage, thus suggesting the ischemia was again related to spasm under conditions of the stress test.I was recently advised to have a cardiolite stress test "to more clearly define" my problem. I have 2 questions: 1)In your opinion, does the cardiolite stress test really add any new useful information for my prognosis or treatment(I am currently on verapamil), especially so soon after the other tests, and 2)Would it be wise to go back to my past profession with its attendant high stress in view of my recent test results?
Thank you for your response and I apologize for the length of my discourse. CLG
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Dear Charles

The cardiolite stress test is not really different from the Thallium stress test. I suspect your doctors want to see if the test result is better on medication. However, these tests are not really useful in diagnosing spasm, which is in fact a rare diagnosis. Spasm is even rarer in patients on medications like verapamil. The definitive way to diagnose spasm, is to do a cardiac catheterization and give an agent that provokes spasm. This test was invented at the Cleveland Clinic. Few places know how to do this test anymore, because spasm has become even more rare. If the diagnosis is really being considered, the choices are to treat you with medicines like verapamil and hope for the best or to do the sort of special catheterization I mentioned.

I hope this has been useful. Feel free to write back with further questions. Good luck.

Information provided here is of a general nature. Specific diagnoses and treatments can only be made by your doctor. If you would like to be seen at the Cleveland Clinic, please call 1-800-CCF-CARE for an appointment with a cardiologist at Desk F15.

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