Nuclear Scan as effective as angio-gram?

[aheart]

My doctor now thinks its too risky to do a angio-gram to check my arteries in my heart. Has anyone had a nuclear scan and how does that stack up in comparison to an angio?

[ed34]

There is a risk with anyone getting a heart attack or having a stroke during an angiogram because of the reasons you state. Perhaps there was a note from a previous procedure saying you had plaque in your femoral artery or in your left main stem. If this is the case, then the risk is obviously higher. The majority of people have a clear run up to the coronary arteries, and the catheter doesn't have to be put very far inside these to obtain images.

[aheart]

They are afraid to disturb plague formation and cause a blood clot. Should I question this or get a second opinion? I got a stent placement in 09' but recently had angina & abnormal EKG and blood test came back high. 0.20 in a normal range 0.0 to 0.1 Thank you.

[erijon]

A nuclear stress test is far less invasive and involves stressing the heart, usually on a treadmill while hooked up to an EKG and injecting a tracer. Pics are taken before and after to see if there are any areas of the heart that do not show tracer uptake which would mean there is some blockage causing a lack of blood flow to the affected area. These tests are about 85% accurate but have a specificity of approx 95% which means they will find CAD when present about 95% of the time. Unfortunately they also have false positives as well so they are good, but not as good as an angiogram which is 100% accurate.

Why does your doctor feel and angio is too risky?

Jon

[ed34]

nuclear scans are very different and show the area of oxygen deficit, not the artery causing the problem. They are nice glowing images showing the level of oxygen.
example...
http://www.google.co.uk/imgres?imgurl=http://www.cedars-sinai.edu/Patients/Programs-and-Services/Heart-Institute/Research-and-Outcomes/Cardiac-Imaging-Research-Team-CIRT/Images/nuclear-scan-12141.jpg&imgrefurl=http://www.cedars-sinai.edu/Patients/Programs-and-Services/Heart-Institute/Research-and-Outcomes/Cardiac-Imaging-Research-Team-CIRT/CIRT-Core-Laboratory.aspx&usg=__HVFFnBXBYx7s-joOfVIa-J-ggYY=&h=480&w=640&sz=72&hl=en&start=0&zoom=1&tbnid=xOiU0t4xM5u8kM:&tbnh=122&tbnw=167&ei=Nz1ATai4HNKwhAf4ntGhAw&prev=/images%3Fq%3Dnuclear%2Bscan%26hl%3Den%26sa%3DX%26biw%3D1008%26bih%3D661%26tbs%3Disch:1%26prmd%3Divns&itbs=1&iact=hc&vpx=291&vpy=73&dur=3032&hovh=194&hovw=259&tx=79&ty=115&oei=Nz1ATai4HNKwhAf4ntGhAw&esq=1&page=1&ndsp=21&ved=1t:429,r:1,s:0
An angiogram is for showing up the lumen in the arteries, the space for blood to flow. It doesn't show the actual blood entering the muscle tissue. So, each scan has its values but each is very different.
Angiogram example...
http://www.google.co.uk/imgres?imgurl=http://www.heart-valve-surgery.com/Images/coronary-angiogram-picture.jpg&imgrefurl=http://www.heart-valve-surgery.com/heart-surgery-blog/2007/09/03/danger-of-angiogram-risks-of-angiography/&usg=__8O7Q2JgzVut_ylSKIyi0qHylWn4=&h=380&w=400&sz=119&hl=en&start=0&zoom=1&tbnid=sqI7fsmQU14SEM:&tbnh=154&tbnw=162&ei=3D1ATcn2Lo-zhAeqxbiWAw&prev=/images%3Fq%3Dangiogram%26hl%3Den%26sa%3DX%26biw%3D1008%26bih%3D661%26tbs%3Disch:1%26prmd%3Divns&itbs=1&iact=hc&vpx=249&vpy=111&dur=694&hovh=219&hovw=230&tx=101&ty=132&oei=3D1ATcn2Lo-zhAeqxbiWAw&esq=1&page=1&ndsp=15&ved=1t:429,r:1,s:0