Should a nuclear stress test be performed by a cardiologist? My father, who is 82, is scheduled to have basal thumb arthritis surgery on the 15th of Feb. His doctor of internal medicine wants to do a nuclear stress test to make sure his heart is strong enough to be subjected to general anesthesia. He has leaky valves. We are concerned that this may be a procedure that should be done by a specialist.
Your doctor of internal medicine is a specialist. Although they are not cardiologists, they have significant training in cardiology. My first and third stress test were performed under the supervision of a family practice doctor and it was interpreted by a pathologists. The second was done by a cardiologists in a heart clinic away from my small home town. The results of all three were similar. There is no question in my mind an internal medicine specialist is well qualified to do a nuclear stress test. The fact your doctor is displaying the level of caution regarding your father's safety should be a comfort to you. As you and your doctor well know, there are risks with general anesthesia with the elderly. I hope it goes well for him.
It is my understanding that a cardiologist must be in the department when a stress test is being administered. I'm sure that in smaller testing facilities they have specialists that are trained to respond in the event there is a complication. I have had one each of the past three years and there has always been a cardiologist present.
I don't think I'd do a nuclear stress test for my primary care doctor. He's a pretty sharp kid, but I'd have to say totally unqualified in the nuclear stress test area. From the experience I've had with these tests, I would doubt that a PCP would even have access to the needed equipment.
Just to clarify previous comments regarding Primary Care Physicians doing nuclear stress tests. I live in a Wyoming town of about 7500 population. We have excellent medical facilities and health care, but we do not have access to a lot of specialists. Many people outside of cities have similar health care situations. The internal medicine specialists take care of a lot of the heart patients, though we do have weekly visits from a cardiologists who travel from another town. Nuclear scans are routinely performed here without a cardiologists present. The expertise needed to read and interpret them comes from our pathologists.
Ideally, most of us would prefer our heart care to be totally in the hands of a heart specialist. We do not have what is ideal, but it does work reasonably well for us.
I find it kind of interesting that some of you have had cardiologists actually performing your tests. I'm a Nuclear Medicine Technology student and we perform stress tests without physicians present all the time. There must a physician close by, but there has never been a need to have a cardiologist do the test. That is what the Nuclear Medicine Technologist is trained to do. The cardiologist will read the results of the test, but never have I heard of the cardiologist actually doing the test. I also live in a pretty heavily populated city and I work in a pretty good sized hospital.
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