Do you recommend further testing?????????????????

[Barbara__0__0]

  I am a female, insulin dependent (12 years) diabetic, high blood pressure,
  and have trace protein in my urine (Start of kidney disease). I take Lotensin,
  Atenolol and Plendil for blood pressure which is now finally near normal. My
  Problem:  Since December I have had cronic bouts of shortness of breath.  I
  had a stress test/thallium scan in December and the doc said it was OK.  I
  learned from your forum that the thallium scan could give a false negative
  in women.  My doctor feels that the thallium scan was an acceptable workup
  for me.  He consulted some of his colleagues who said more tests would be
  more likely to have false positives.  He said I may want to talk to a
  cardiologist about a cardioac cath but he wasn't making any recommendations
  either way.  My blood pressure is close to normal but I still have the
  pressure in my chest most of my waking hours.  Should I wait for awhile, get
  another opinion or could my breath problem just be anxiety?  With my kidneys
  starting to go I know all the complications can start to manifest
  themselves.  Thank you so much for your time.  I am sure you have litterly
  been lifesavers!!!
  Barbara

[CCF CARDIO MD DLB]

_
Dear Barbara
If someone stated that a thallium scan is more likely to provide a false negative in women than in men, they were incorrect. They may have meant that exercise treadmill testing is less accurate in women than in men.
Anyway, regarding your situation, I am concerned about your relatively new-onset symptoms. You do not mention your age. Nevertheless, with long standing diabetes, high blood pressure, and proteinuria, your risk of coronary artery disease is quite high. I would recommend seeing a cardiologist for further evaluation. There is a reasonably high probability that any cardiologist you see would proceed with a cardiac catheterization, which would be my bias based on the limited information you have provided. I might also get an echocardiogram first to look at your heart's pumping function.
I hope this has been useful. I wish you the best of luck. Feel free to write back.
If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire online by using the Heart Center website at www.ccf.org/heartcenter.   The Heart Center website contains a directory of the cardiology staff that can be used to select the physician best suited to address your cardiac problem.