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Was acardiac cath necessary

My husband had a 1.0-2.0 mmhorizontal/downsloping ST depression in the inferolateral walls on a stress test.  exercise capacity above average for his age.  Lv functions all normal LVEF 70%.   Dr. wanted to put stents in. and  did not want a ct of the arteries done although we asked about one.  Husband had a card. cath  which showed no blockage so no stents were put in.  What indicated the need for a card. cath. based on the ekg  changes on the stress test.  He is 69 & in good health otherwise.  He was told he had a 75% chance of a heart attack when he got the stress test results.  Thank you.
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Avatar universal
The significance of ST depression on a stress echo ekg is a matter of degree, and possible non-cardiac contributing factors. You just can't make that kind of blanket statement.
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Avatar universal
Your reply was very useful up to the point when you resorted to "a wakeup call for you and your husband."  As your comment indicates, the "wakeup call," needs to be for the physicians who inadequately explain the need for a procedure, what will be done if X is discovered, and its risks and benefits.

As you note, stenting does not decrease the chances of a future heart attack in any significant manner.  Nor, as I understand it, (which may be completely wrong), will angioplasty.  None of the latter will "cure" heart disease - at least nothing I have read indicates that they will.

As much as we'd like to be fully prepared with all the right questions prior to agreeing to procedures, at the 11th hour, as I am facing, all the notes in the world do not take the place of poorly-conducted non-invasive testing, poorly-explained rationale for having invasive procedures, and, the resultant fear.  For me, I'm exhausted from trying to get the information I needed, to the point that I'm ready to agree to follow their "fools gold standard" protocols, all the while knowing that what I'll end up with is more pain and confusion, because to spend another entire day and evening paralyzed with fear is not living.  Let's just hope that the decision to agree to their recommendations does not create a worse outcome.
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63984 tn?1385437939
Certainly a doctor who ignored an ST depression wouldn't be my doctor for long.  Like Ger57 suggests, a heart cath is the best way to determine heart pressures in the heart chamber.  An Echocardiogram would check valves, etc.  Any test or procedure will give you more information, and believe me, information about the heart is priceless.  
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11548417 tn?1506080564
ST depression during the stress test is a strong indicator for ischemia. That must be the reason they told you that there was a chance for infarction. The next logical step is heart catheterisation as this is still the gold standard for finding blockages. As they did not find any, they of course did not place a stent. So, my answer is yes.
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Avatar universal
I don' t know enough to know which test may have been best for him.
A nuclear profusion test,  a CT angiogram,  or a cardiac cath.

Having said that,  the doctor who was intent on putting in a stent should be asked why?  Even if he had found a blockage of 70% or greater,  he needs to be asked why he would want to put in a stent.  Studies don't indicate a better outcome.   Only symptom relief.

Your husband appears to have no angina,  correct?
There aren't,  from what I know, any studies showing that placement of a stent will prevent a heart attack,  or lessen the probability of death.

Of course, depending on the details,  your husband may want to take some significant steps to change his lifestyle.  Perhaps even a statin if his lipids are way out of line.
You should always ask the doctors why they want to do such a procedure (short of being in the emergency room with a ongoing heart attack)

But just because the cath did not show a blockage,  doesn't mean there aren't large changes in lifestyle that may be beneficial.  
A wakeup call for you and your husband.

You would do well to get a second opinion from another cardiologist regarding the causes of the 1.0-2.0 mmhorizontal/downsloping ST depression and anything you might do to lessen future dangers.
Helpful - 0
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