Physician care and testing

[Eileen C.]

In October 1997 my husband had a heart attack.  He was 42 and in relatively good health.  He underwent an angioplasty to clear the artery and had a stent implant.  He underwent a thallium stress test after the procedure that gave a conflicting response to the ekg. His cardiologist repeated the angioplasty to make sure the stent had remained in place.  The procedure went fine and the stent was in place.  He is now under the care of a doctor who practices internal medicine and pulmonary medicine. He has prescribed 50mg of Metoprolo twice daily, 10mg of Zocor once daily, 10mg of Accupril once daily and 325mg aspirin.  This doctor doesn't feel my husband needs to see a cardiologist.  He has also given us the option of having another thallium stress test.  In his opinion the test is not necessary since it would give the same result it had right after the heart attack. My husband has gained some weight and does not get any regular exercise (he also works too hard).  I try to see that he eats a low fat diet.  The doctor has suggested my husband lose the weight and exercise more.  My husband likes this doctor which makes it easier to get him in for his regular quarterly appointments. I am a little skeptical of the doctor's opinion.  Is this doctor handling my husband's heart problem correctly or should I urge my husband to see a cardiologist and have the stress test?

[CCF CARDIO MD - DLB]

Your doctor seems to be taking good care of your husband. He has him on good medications and his advice sounds reasonable. If your husband is not having any new symptoms, there is no clear evidence that he should just get a stress test anyway. Nevertheless, I usually would recommend that such a young person with heart disease also be followed by a cardiologist, just in case he runs into heart trouble again in the future.