Abnormal Thallium Stress Test

[janef]

I was sent for a Thallium Stress Test to rule out heart problems related to unexplained chest pain.  I received a message from my PCP that stated there was a glitch in my test and he is having me follow up with a cardiologist.  He stated that he does not think my test is a true abnormal, that they see a lot of false results in woman due to the breast interfering with the xray's of the heart.  I have no idea what factor caused my test to be abnormal, but just wondering what to expect from here.  Is there a normal routine of testing after an abnormal Thallium Stress Test?  I am a real worry wart and of course, scared to death!  Any info you can offer is greatly appreciated.  Thank you!

[CCF-M.D.-CRC]

Dear janef,
The technical description for what your doctor is talking about is called "breast attenuation".  This means exactly what you said that the breast tissue causes a decrease in the image intensity in that area.  

There are several approaches that could be taken at this point.  If it is clearly breast attenuation then nothing additional needs to be done.  If there is a concern that this may represent an area of ischemia (decreased blood flow) then additional testing such as a stress echocardiogram may be performed or your doctor may recommend cardiac cath.  In any case I wouldn't worry too much until all the test results are in and a diagnosis is made.  It could be many things at this point including a normal finding.

[wingtip]

When I had my Abnormal Thallium Stress test results, it turned out that it was a dense spot by the spleen, which was ruled not to be a heart problem by a cardiac cath.  When I went for a different type of imaging, the same problem showed up, thank goodness it had already been ruled out by the cath.  It seems like these types of tests have quite a few false positives.  But if it saves doing a cardiac cath. on 50% of the people with chest pain, it is a good enough test.

[amy rn]

If you're middle age a woman can show a false positive in regards to a stress test because of hormones. Further testing such as following up with a cardiologist can either rule out any heart problems or confirm a heart condition that may need treatment. A cardiologist is the best person to follow up with-there's comfort in knowing someone so knowledgeable is either telling you you're heart is healthy or treating a condition that he is specialized in. Good luck-I'm sure you're results will come back just fine. Amy

[janef]

Amy,
Thank you for your reassuring comment.  I just turned 35 and hope and pray that it is in fact a false positive.

Hugs,
Jane