Type of test needed

I an a 72 year old male. I underwent quadruple heart bypass surgery in 1990 and angioplasty in 1993. Since then I was given a thallium EKG stress test in 1995, and an EKLG stress test without thallium in 1998;these two tests indicated no problems, but my heart rate did not exceed 120 beats/min during either test due to a beta-blocker I was taken (I was not advised to discontinue the beta-blocker proior to the tests). Then, just recently, I was given a stress echocardiogram test. However, for some reason the test results were inconclusive. The cardiologist felt I did not need any additional testing, since I was able to continue for 8 minutes on the tredmill, and my heart rate increased to 150 beats/min during the test (I had stopped taling the beta blocker prior to the echocardiogram test).

Sionce the echocardiogram test was inconclusive, it seems to me that I should be given a thallium EKG stress test now -- this type of test indicated the neeed for my heart bypass surgery and also the need for angioplasty in 1993. It has now been 10 years since my bypass surgery, and 5 yearts smnce my last thallium EKG stress test. I would greatly appreciate your opinion as to whether I should take an EKG stress test withn thallium in th near future.

[Cleveland Clinic, MD]

Dear Franklin,
You have stepped right into the middle of a controversy amongst cardiologists.  There are two camps - thallium and echo, with each saying their test is the best.  Actually they are probably pretty close to each other.  The pros and cons of each are beyond the scope of this forum.  What you may want to do is ask for a thallium next year - that way everyone will be happy.