Posted By chris on May 12, 1999 at 10:12:08
I hope you don't mind me asking two questions in a row. I have a friend whose husband (51 yrs old, elevated lipis under
controlControl
Control rx, poor
familyBirth control and family planning
Choosing a primary care provider
Ewing’s sarcoma
Family troubles - resources history, was complaining of shortness of
breathBreath alcohol test
Breath holding spell
Breath odor and had a treadmill stress test done which was
normalNormal saline flush. His doctor ordered a
thalliumThallium and sestamibi stress tests stress test "just to be sure" which showed a
blockagePeripheral artery disease in the right coronary artery. He then had a cardiac cath and angioplasty scheduled. Why would the thallium test show something the treadmill did not? Should a thallium test be done when symptoms persist even if the treadmill is normal? The reason I am personally interested in this is that when I started on a fitness program (the reason I started!) I couldn't climb more than a few landings of stairs or climb hills without exhaustion, shortness of breath, and upper chest discomfort. (not pain, just a feeling of discomfort) The stress treadmill test required because of my age (not old enough to require physician supervision) was normal. I didn't seem to have this problem with hills when the technician increased the grade of the treadmill.I thought maybe I was out of shape. After 6 months of the exercise routine, I can climb stairs without much discomfort other than what you would normally expect from someone my age. (48 yrs,female) However, I still have a problem with hills, especially if I am carrying something in my arms. I'm usually okay if I go slow and balance the weight between both arms. After hearing of my friend's experience, I am a little worried. I don't want to be an alarmist but I also don't want to collapse on the street. Thank you for your response. I find it fascinating reading the doctors answers to all the questions! Chris
Dear Chris,
What you have touched on is actually a very complex topic and one that whole books are written about. The simple answer is that the treadmill test is more likely to have a "False negative" result than the thallium. This is where clinical judgement and experience comes to play and was beneficial in your friend's case. In your case your doctor may or may not want to pursue further testing. Are you having the discomfort only with exertion?
I hope you find this information useful. Information provided in the heart forum is for general purposes only. Only your physician can provide specific diagnoses and therapies. Please feel free to write back with additional questions.
If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire online by using the Heart Center website at www.ccf.org/heartcenter. The Heart Center website contains a directory of the cardiology staff that can be used to select the physician best suited to address your cardiac problem.
Thanks again for your response to my questions. I seem to only have problems walking up hills. I can go through an entire step aerobic class,(getting my heart rate up to 120, after that I feel kind of crummy) gardening, walk briskly, and now climb stairs, with no problems, but as soon as I try to climb a hill I have problems. I especially notice it if I am carrying a tote bag of books. I have the discomfort to a lesser degree if I'm not carrying anything. I see the doctor in August for a followup. I take 25 mg atenolol for episodes of high blood pressure.(had the hill problem before the atenolol was started) I still haven't decided what to do about the cholesterol situation and will be retested in August. My total cholesterol is now below 200 (193) through diet but my HDL is still poor (26) despite 6 months of regular exercise. I'm not sure about my family history. Parents are okay, but my father's mother, her father,and all 3 of her brothers died of strokes by age 60 and all of the descendents of these brothers (all male) have had bypass surgery. Two of my father's sisters died of heart attack in their late 50's. I don't know if this puts me at risk. I started to worry when the high blood pressure was diagnosed (6 months ago) and that's why I've been so interested in the cardiac questions. I'll ask my doctor about the homocysteine level in August too. Thanks!
Follow Ups:
Re: treadmill vs. thallium stress test CCF CARDIO MD - CRC 5/12/1999
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treadmill vs. thallium stress test Melissa Lanham 5/12/1999
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Re: treadmill vs. thallium stress test CCF CARDIO MD - CRC 5/13/1999
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