Posted By gillon on July 13, 1999 at 13:18:11
Regarding my last message: I spoke with my doctor yesterday (a cardio-pulmonary specialist) about whether I should have a
thalliumThallium and sestamibi stress tests stress test.
He recently gave me a stress-echo which was
normalNormal saline flush (except for slight leakage and slight thickening of the
mitralMitral regurgitation - chronic
Mitral stenosis
Mitral valve prolapse valvesHeart valves
Heart valves - anterior view
Heart valves - superior view-no MVP)-He said no restrictions after this test, meaning I could exercise as often as I like. I am a 33yr old male with no
familyBirth control and family planning
Choosing a primary care provider
Ewing’s sarcoma
Family troubles - resources history of heart disease (Grandfather died of heart attack at 68 but was alcoholic)-am 6ft, weigh only 160, smoked for 11 yrs, but not heavily and quit almost 2 yrs ago.As I mentioned before, I have a history of chest pain and arrythmias during the past four years, all thought to be
panicPanic disorder
Panic disorder with agoraphobia related, or not dangerous. I mentioned before I recently had chest pain after jogging,-it was very fast, but strong enough for me to stop (but I was not short of breath) and also on an airplane for several minutes. I am concerned about this.
QUESTION:#1. Could my stress echo have been negative? I take 50mg of Atenolol and did not stop it for the test.Maybe that masked the problem.My doctor said I am in great shape and finds it hard to believe after all of the testing that I would have coronary artery disease.
#2. Should I have a Thallium stress to be safe? Or is it a waste of money?
#3. What is the best test(also safest) for CAD-Thallium, Angiogram, PET scan,or CAT scan.
#4. Should I spend more money on testing or wait and see If I have more symptoms during exercise. I have to mention it is strange that I have chest pain mostly at rest (but not often) and not during exercise. What about the possibility of a Coronary Artery Spasm?-sorry this is long. Thankyou.
Dear Gillom,
In response to your questions.
#1. Could my stress echo have been negative? I take 50mg of Atenolol and did not stop it for the test.Tests can always be negative however, if your pre-test probability of CAD is relatively low as in your case. This is probably a very good test assuming your heart rate increase to approximately 140 beats per inute.
#2. Should I have a Thallium stress to be safe? I would not recommend further testing unless your primary physician is concerned. Sounds like they are not.
#3. What is the best test(also safest) for CAD-Thallium, Angiogram, PET scan,or CAT scan. Best and safest are two different things. The gold standard for CAD determination is an angiogram, but there are risks. If it is done in an experienced center however, these risks are very low. Of the above mentioned non-invasive tests a PET is probably the best.
#4. Should I spend more money on testing or wait and see If I have more symptoms during exercise. I would monitor your symptoms and see how you progress. If this might be spasm, your doctor might consider a calcium channel blocker.
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