I want Your advice!

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My husband had a heart attack in June of 2005, exactly two weeks afer passing a nuclear stress test. He had a 95 and 80 % bockage and was stented. In July of 2006 he had another attack caused by a blood clot from the drug coated stent, so we were told. He had a nuclear stress test done three weeks prior to this attack which he again passed but we knew from the first cath he still had another 60% blockage.

The 2nd attack he had to have by-pass and was in critical condition so they only by-passed the one stent. He changed cardio's as the first group would not return phone calls about his B/P even from home health care nurses.

This new cardio we are very impressed with, he listens, answers all your ?? and says never hestiate to call if there are changes concerning your heart.

He is watching my husbands heart by doing Echos to check the blood flow. he said if the blood flow is good there are no major problems, although the Echo cannot check for blockages, he said the blood flow would lessen if the blockages get worse. Can we depend on this as we certainly cannot depend on the nuclear stress test?

Thank you so much and a have a wonderful Easter, Line

[Forum-M.D.-MJM]

Hello,
I wouldn't lose faith in nuclear studies so quickly.  One inherent problem with stress testing is that it predicts blood flow problems around already existing blockages.  The majority of heart attacks come from areas in coronary arteries with blockage that would not/should not be stented or bypassed.  What I am saying is that stress testing is meant to predict heart attacks, it is an assssement of stable coronary disease.  The physiology of the two processes are very different.  There is no good test yet to predict when an unstable plaque is going to rupture.

On the other hand, stress echocardiography is just as good as nuclear studies in assessing chronic stable angina.  The key is understanding that a negative stress test doesn't mean you are not at risk for a heart attack, it means that you don't have any blockages at that moment that cause significant blood flow impairment with stress.

I hope this answers your questions.  Thanks for posting.

[EchoTech]

I always highly recommend an echo stress test, but then again, I'm biased.

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I wanted to let you know that I was put out of rehab again because of symptoms while exercising and nausea afterwards plus oxygen levels.  I am scheduled to see the cardo tomorrow.  I also passed the T stress test just before surgery.  The CC doctor gave a good explantion about it. I felt it was a waste too.  My neighbor had 90% blockage and passed it.  I always wondered how I passed it when I was so sick.  I get jaw (slight) and chest ache exercising at rehab plus I got nausea at the end of the treadmill time. What bothers me most is the symptoms I get at rest.  They said that my blood pressure goes high and I can't get the heart rate down.  Do you think it is the blockages or could diffuse blockage cause it.  I do not know if I have diffuse blockage. They think it is the LAD.  I am playing doctor.  I am wondering what they will do if the blockage has not changed.  I hope they do not stent it because of symptoms.  Can they do angioplaspy instead of stents?  Thanks again

[38DDD]

66yr old female with B/P avg of 135/80 /on Lotrel10/20.... great HDL,10-12lbs overweight
Had first stress test today (MYOView) Threadmill was a piece of cake, but my question is about the imaging. Tech told me there was a shadow, likely from my breast & Doc might want to re-take.images...How often does this happen?
Should I be concerned? Thanks for any input