Angioplasty Followup

[Cody]

Dear Physicians,

Approximately 2 1/2 years ago I had angioplasty performed on my LAD because of a 95 per cent blockage.  Since then I have had annual thallium stress tests and annual regular stress tests.  All stress test results have been normal and similar.  I jog about 30 minutes each day and never feel chest discomfort.  However, on occassion I do feel a chest discomfort while at rest that can last for a day or two.  My daily medications consist of hydrodiuril, atenenol, imdur, vasotec, pravachol, and aspirin.  I have discussed the chest discomfort with my cardiologist and he believes it is due to atypical angina(not heart related) because of the normal and similar stress test results and because it never occurs while jogging.  Are annual thallium stress tests a good indicator of the progress of the lesion?  Should they be conducted more often(in other words how long a period is the results of this type of test valid)?  Are there any other more definitive tests(pet scans, etc.)?

Thanks - Jeff

[Cleveland Clinic, MD]

Dear Jeff,

Chest pain that lasts for days is not typicaly due to blockages in the arteries.  Annual thalliums are a common way to follow coronary artery disease.  PET scanning is used in some circumstances but is only available in large centers.   Typicaly angina (lasting minutes, occuring with exertion, etc.) is one of the best indicators of the progression (or lack thereof) of blockages. Best wishes.