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safety of nuclear stress test
Hi.
I'm a healthy, 50 year old male.  I have no symptoms of heart problems, but I have a family history of heart disease.  Is a nuclear stress test advisable or is there another test that would be more appropriate given the fact that I'm asymptomatic.  I understand that the radiation exposure in a nuclear stress test is 250 times that of a chest xray.  I'm concerned about the risk of exposure to that level of radiation given the fact that I have no signs of heart problems at this point.
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KLP613
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592969 tn?1248329005
Why are you having the nuclear stress test with no symptoms?  What prompted you to seek medical attention for heart problems?  The nuclear stress test does not tell everything and does have a high level of radiation.  The best procedure for the heart is the angiogram (but that again carries some risk).  Be careful.  
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Thanks for responding.  My doctor recommended the test due to my family history of heart disease.
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212161 tn?1432037254
hi klp just wanted to say am 49 and just had the stress/nuclear test. didnt want to because i was scared of the test opr just didnt want to take 4 hours of my day there , but guess what it was so easy.  i was going to walk the treat mill but i had worked myself up all week to where my bp was 176/106 so they would not let me walk, so i got to take the shot which i told them i didnt want and i would come back another day when bp down, but before i could get out mouth they stuck the shot in . so off we went.

mt heart started racing and it scared me more they got my heart rate up to 171 in seconds, but it would not drop back down because i was so stressed over test , so she came back in gave me another shot as soon as it started going in my heart rate came back to 99 than mins later back at 56 where it stays. so it really was not bad. if you want to walk and can  do it if not you will be in good hands they know what they are doing.

as far as the test , it will not show any blockage under 70 percent, only above but it does show the ef of your heart and other things. so yes you should do the test, its fast and easy and gives a little peace of mind. all other test i ask about are like the scann but most insurance wont pay for that one they told me its 7000, and they have to drop your heart rate in to the 50-40 so this is best test. do it to be safe with it running through your family let us know how it went for you . God Bless

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367994 tn?1304957193
Your doctor is correct if there is a family history of heart disease, a competent doctor will recommend tests BEFORE there are symptoms.  And the test should involve the anatomy of vessels not just the lumen looking for plaque with a cath (not appropriate for asymptomatic individuals with a family history).
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This is the reason: Atherosclerosis, which typically begins in later childhood, predominantly produces artery wall thickening and artery enlargement, not lumen narrowing. Lumen narrowing typically occurs as part of healing responses after vulnerable plaque ruptures, most of these ruptures being clinically silent.  Dislodged clots from soft plaque (residing outside the lumen) rupturing is the major cause for an MI.

The lumen narrowing represents only a SYMPTOM of very advanced disease, a state which typically requires several decades to develop. Additionally, no stress methods quantitatively measure actual or needed blood flow to the heart muscle. They only detect imbalances of blood flow between regions of the left ventricular muscle which are beyond the capabilities of the arterioles in the downstream vascular bed to fully compensate.

Regarding the risk of radiation:  A  scan corresponds to the dose of 250 chest x rays, or an extra cancer risk of about 1 in 16000 exposed patients. The lifetime risk of fatal cancer development is 4%/Sv or 0.004%/mSv or about 0.1% for a  scan.

The best test for a family history of heart disorders is the CT scan 64-slice!  Not the intervention of a cath.  The calcium score from the ct scan will determine the health of the vessels and provide a basis for any progression..
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Thank you for your comments and assistance.  I appreciate the time you took to help me with my decision.
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