EKG test questioned

[gjmc]

My doctor wanted me to have a routine physical . My cholesterol and BP were in the normal range as were all other parts of the blood work. He wanted me to have an EKG since I had just turned 51. It showed that I had a previous heart attack. I was shocked since I have never had any chest or arm pain and no shortness of breath or tiredness. He wants me to have a nuclear stress test which I am balking at since I'm having trouble believing the EKG. Any advice?

gjmc

[Bettycit6760]

Just had nuclear two weeks ago.  It was a breeze.  The first doc wanted to do an angiogram after a routine stress showed tach.  I requested a nuclear and he flat out refused.  I found another doctor.  I think the angiogram is too invasive since I had no symptoms of heart disease and after comunicating with ken keith here on med help who urged me to have a nuclear.  With the new doc  the nuclear and echo showed no clogged arteries.  Will return in one year for follow up.  The tests showed my left ventricle was only functioning at 40% instead of 60%.  Started on a beta blocker.  No restrictions on activities.  Have the nuclear is my choice.   Good Luck.  Keep us posted.

[hcurrie]

repeat the ecg first if the attack still shows then the nuclear test is the next step - i have had two they are no biggie at all

[erijon]

I have to agree with Flycaster, an angiogram would certainly be almost 100% accurate, but I doubt your insurance company would cover it. Also, most cardiologists will not do an angio until they have an abnormal nuclear stress test result as there is a risk with an angiogram, small as it may be.

I have had 2 nuclear stress tests without any bad side effects. Nuclear stress tests are between 85 - 90% accurate without being invasive. Also, as Flycaster said, EKGs are often read by a computer these days and are quite often wrong. Mine shows an old artifact which has been on my EKG since I had my first one 25 years ago and my tests show that no such artifact exists, go figure.

Good luck!

Jon

[Flycaster305]

I agree with Encepholomalcia, an angiogram is the gold standard to determine blockages, etc.  However, insurance companies often require less invasive procedures precede the  angiogram.  I've had nuclear stress tests and they have been extremely accurate, and it's not an invasive procedure.  I think the word 'nuclear' scares most of us, but it's very safe.  
Heart attacks are very often silent, with no symptoms.  That being said, ECG tests are often wrong.  I've had at least ten angiograms and many stents, but I always ask for a stress test first.  
I'd procede with the stress test.  

[Encephalomalcia]

Questioning why the doctor wants you to have a nuclear stress test verses a regular stress test.  People can have an reaction to the nuclear stress test.  The test is not perfect.  The only true test, which is a procedure, is the angiogram.  My mom had the nuclear stress test and was told that it was not bad and a few months later she was totally plugged in two main arteries and about 99 percent plugged in the other.  Have you had an echocardiogram yet?  An echocardiogram can check the heart valves.