how accurate are heart caths, i took a nuclear stress test which showed reversible ischemia ,and the my heart gets bigger when exercising when it should get smaller. it also showed heart thickening. i had a heart cath and he said my heart looked good, should i get a second opinion or are they 100 % accurate.
I think if I was in your shoes, I would first maybe wonder if 'both' tests are accurate and have given true readings to the best of their ability. The perfusion (nuclear) scan has revealed reversible ischaemia which means blood flow to an area of heart muscle is restricted. The angiogram shows that your major coronary arteries are clear. The two tests may lead to the same conclusion, or the nuclear scan could have given inaccuracies when trying to penetrate body tissue to reach the heart. Let me explain how both tests could be correct.
An Angiogram can only look at fairly large vessels, the small vessels do not show up. The larger coronary arteries do not directly feed your heart, they break down into smaller and smaller vessels untl they are the narrower than the width of a hair, and then they feed oxygen to the heart. Imagine the roots of a plant. The large roots are your main coronary arteries which feed all the smaller roots hanging from it. When you get to the tiniest roots, these are feeding your heart. So, the angiogram may not be seeing problems that could be occurring in the smaller vessels.
If your cardiologist says that there is nothing wrong with your heart and that the nuclear scan is at fault, I would ask "How do you know that? how do you know the nuclear scan isn't correct and my smaller coronary arteries aren't blocking?". Its so easy to disregard one test for another but you can end up losing the trail leading to the cause of any problems that way.
I hope I have explained this in a way easy to follow, I get very finger tied when trying to explain things at times.
I'm not sure if they can tell. The problem is they are so tiny, microscopic. Are you getting angina symptoms when you exercise? or do symptoms appear at any time?
If with exercise, there is a 'possibility' it could be your tiny vessels. If symptoms appear at random, then it could be you have unstable angina. The best method to test if you have narrowing vessels is to take Nitro when you feel discomfort. This forces your arteries to open fully and should relieve any symptoms. The side effect is a headache for about 20-30 mins while your blood pressure has dropped.
Sorry, I meant to add.....
It could be that the nuclear scan was in error, but I'm simply saying don't let them dismiss the possibility that it 'could' be accurate. Just becaue it doesn't match your angiogram doesn't make it wrong.
Quote: "How accurate are heart caths, i took a nuclear stress test which showed reversible ischemia ,and the my heart gets bigger when exercising when it should get smaller. it also showed heart thickening. i had a heart cath and he said my heart looked good, should i get a second opinion or are they 100 % accurate".
>>>What do you mean your heart gets bigger when exercising when it should get smaller? What test or how was there a conclusion of heart thickening? Did you have an echocardiogram? If so, what are the dimensions of your left ventricle?
For a perspective of stress test and cath. With over 1.3 million stress echocardiography tests performed each year with a 10-15% failure rate, there are potentially over $100 million unnecessary or clinically unreliable stress echocardiography tests done each year. This stress echo failure rate results in an increase in the number of nuclear perfusion stress tests, which are known to have a high incidence of false positive results. A false positive cardiac stress test may increase the number of expensive, unnecessary cardiac catheterization procedures and their associated required hospital stay and added anxiety, discomfort and medical risk for the patient. The significant number of false negatives from stress echocardiography tests may increase the risk of heart attacks and sudden death from undetected advanced coronary artery disease (CAD) and/or successful earlier intervention in early stages of CAD.
I would get a second opinion as there are serious implications and consequences with any mistakes.
the cardiologist said that my heart got bigger when it should get smaller. dont really know what he meant by that. the only test i have had was a nuclear stress test chest xray and a left heart cath. he said i had uniformed thickening results from the stress test. thanks for all the advice.
This site complies with the HONcode standard for trustworthy health information.
The Content on this Site is presented in a summary fashion, and is intended to be used for educational and entertainment purposes only. It is not intended to be and should not be interpreted as medical advice or a diagnosis of any health or fitness problem, condition or disease; or a recommendation for a specific test, doctor, care provider, procedure, treatment plan, product, or course of action. Med Help International, Inc. is not a medical or healthcare provider and your use of this Site does not create a doctor / patient relationship. We disclaim all responsibility for the professional qualifications and licensing of, and services provided by, any physician or other health providers posting on or otherwise referred to on this Site and/or any Third Party Site. Never disregard the medical advice of your physician or health professional, or delay in seeking such advice, because of something you read on this Site. We offer this Site AS IS and without any warranties. By using this Site you agree to the following Terms and Conditions. If you think you may have a medical emergency, call your physician or 911 immediately.