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Heart Rhythm (Expert Forum)
PSVT, CAD and Thallium Test Results
Answered by
Michael J. McWilliams, M.D. - atrial fibrillation, Pacemakers, Defibrillators, Arrhythmias (SVT, VT), PVC/PAC, Ablation
Wilmington Health Associates
Wilmington - NC
Questions in the Heart Rhythm forum cover topics that include heart rhythm issues, arrhythmia, irregular heartbeat, implanted defibrillators, pacemakers, and tachycardia.
PSVT, CAD and Thallium Test Results
by glblue, Oct 27, 2007 07:01AM
I'm a 42 year old male with PSVT, overweight or obese much of my life, but lost 70lbs on Atkins 4 years ago and kept it off - now I'm at a good weight. Former smoker (quit 7years ago). I've had PSVT and PVCs for 6-7 years but the SVT wasn't caught on an EKG until two weeks ago.
In preparation for an ablation for PSVT, my doctor ordered a Thallium Stress test. He says the nuclear imaging "raises the possibility of an abnormality in the lower heart, but I don't think it's clinically significant given your young age and lack of symptoms".
What is meant by "clinically significant"? That I have Coronary Artery Disease (CAD), but no symptoms? or a false positive on the test? How sensitive is the nuclear imaging (would a small blockage show up, or only a large blockage? What is the relationship between the thallium test, PSVT, and CAD?
I'm quite concerned because it will be at least a couple of weeks before my Dr. follow up and I have no guidance regarding whether I should be concerned about a heart attack in the short term pending the next round of tests.
Thanks,
Glblue
In preparation for an ablation for PSVT, my doctor ordered a Thallium Stress test. He says the nuclear imaging "raises the possibility of an abnormality in the lower heart, but I don't think it's clinically significant given your young age and lack of symptoms".
What is meant by "clinically significant"? That I have Coronary Artery Disease (CAD), but no symptoms? or a false positive on the test? How sensitive is the nuclear imaging (would a small blockage show up, or only a large blockage? What is the relationship between the thallium test, PSVT, and CAD?
I'm quite concerned because it will be at least a couple of weeks before my Dr. follow up and I have no guidance regarding whether I should be concerned about a heart attack in the short term pending the next round of tests.
Thanks,
Glblue
Doctor's Answer
by Michael J. McWilliams, M.D., Oct 27, 2007 08:43AM
, Oct 27, 2007 08:43AM
What is meant by "clinically significant"?
Procedural treatment for coronary artery disease should be based on symptoms. If you are not having symptoms of coronary disease -- chest pain, shortness of breath with exertion, new lower extremity swelling, etc, you probably will not benefit from a procedure looking for coronary disease unless the distribution of the blockage is very large.
False positives are more common in woman.
How sensitive is the nuclear imaging (would a small blockage show up, or only a large blockage?
Small blockages can show up. It is a pretty good test but the results depend on how good the reader is and should be interpreted in context of symptoms. It will catch in the mid 70% range of who has coronary disease and has a false positive rate of about 20-25%.
What is the relationship between the thallium test, PSVT, and CAD?
If you have been having these symptoms all your life, there is probably no relationship between CAD and PSVT. The thallium is also probably unrelated to the PSVT. Your doctor was probably making sure you were not at risk for venticular tachycardia and that is likely why they ordered the stress test.
I hope this helps. Thanks for posting.
Procedural treatment for coronary artery disease should be based on symptoms. If you are not having symptoms of coronary disease -- chest pain, shortness of breath with exertion, new lower extremity swelling, etc, you probably will not benefit from a procedure looking for coronary disease unless the distribution of the blockage is very large.
False positives are more common in woman.
How sensitive is the nuclear imaging (would a small blockage show up, or only a large blockage?
Small blockages can show up. It is a pretty good test but the results depend on how good the reader is and should be interpreted in context of symptoms. It will catch in the mid 70% range of who has coronary disease and has a false positive rate of about 20-25%.
What is the relationship between the thallium test, PSVT, and CAD?
If you have been having these symptoms all your life, there is probably no relationship between CAD and PSVT. The thallium is also probably unrelated to the PSVT. Your doctor was probably making sure you were not at risk for venticular tachycardia and that is likely why they ordered the stress test.
I hope this helps. Thanks for posting.
