Stress thallium vs. stress echo

[Kristine__0]

  My question has two parts. The first is, which test is more accurate to determine cornonary blockages, the stress echo or the stress thallium? One doctor told me they have the same accuracy rate, but it seems that doctors more often go with the stress thallium in determining whether blockages are present. Why? About 3 and half weeks ago I had a normal stress echo, but I'm wondering if I should have had the thallium. Can I rest assured that everything is clear if my stress echo was normal? The second part to my question is, I have PAC's all the time and I'm wondering why they occur more often when I do things like bend over, turn over in bed or belch? They also occur more often during exertion. Why does this happen? This all makes me wonder whether the stress thallium would have been a better test because I want to make sure my PAC's (I had 3 PAC's during my stress echo)
  aren't being caused by ischemia. How do I know for sure that's not the case without having an angiogram which I refuse to have unless I have an abnormal stress test because that test is too dangerous and scarey. Plus, I'm sure my doctor won't give it to me anyway. Thanks.

[Cleveland Clinic, MD]

  
Dear  Kristine,
Thank you for your questions.  
Q: Which test is more accurate to determine coronary blockages, the stress echo or the stress thallium?
A: This is an excellent question and one that could be debated at any major meeting of cardiologists.  In general they are about the same.  There are some technical points that make one or the other better for certain individuals that are beyond the scope of this forum.  If you had a normal stress echo there is no point in doing a stress thallium.  If there is still a high concern on your doctor’s part he may consider a heart catheterization as the most definitive test but this would be a "last resort".
Q: I have PAC's all the time and I'm wondering why they occur more often when I do things like bend over, turn over in bed or belch?
A: PAC’s are not due to ischemia and are not usually precipitated by any of the activities you mention.  Perhaps you are just more aware of them during these times or the sensations you are feeling are not PAC’s
Hope this helps.  Feel free to write back with any additional questions.

Information provided here is for general educational purposes only. Only your doctor can provide specific diagnoses and treatments. If you would like to be seen at the Cleveland Clinic, please Call 1 - 800 - CCF - CARE for an appointment at Desk F15 with a cardiologist

[smlpremkumar]

A related discussion, Echo Thallium or Echo Stress Test was started.