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Angioplasty

Dear Physicians,
Approximately three years ago I had an angioplasty, without a stent, performed of my LAD because of a 95% blockage.  Since then I have had four thallium stress tests each about a year apart to check the progession of the lesion.  All tests have shown normal and similar results. A few questions -
What is the accuracy of the thallium stress test and does the accuracy increase when one has the ability to compare results with previous thalliums?  Typically what percentage of blockage is needed to be detected by the thallium stress test?  Are yearly thalliums adequate to follow up a single vessel, LAD, angioplasty?  Finally, are any other more sophisticated non-invasive tests that should be performed?
Thanks - Jeff
12 Responses
238671 tn?1189759432
It is useful for the doctor to be able to compare serial thallium tests. Usually a 70% blockage is needed before detection. In a patient without symptoms, not all doctors would perform a yearly Thallium, though many of our doctors follow this practice. There are no more sophisticated tests that I would recommend.
Avatar universal
Great Questions, Jeff.

I want to know about these Thallium Tests too.

Question:  What is the difference between an angioplasty and a catherization.

Thanks.
Avatar universal
Hi!

Since no one has commented on your comment I will, with a very basic explanation.

A cardiac catheterization is a diagnostic procedure. Apparently there are different kinds, such as a right or left catheterization.  They go in with a catheter, usually through an artery in the groin, and thread their way up to your heart (not sure which vessel) There they can inject dye into the various coronary arteries to see if there are any abnormalities. I am sure they can diagnose other problems as well doing this. A cath is usually an oupatient procedure, unless you have other problems.  

An angioplasty is a procedure where they also go in through a blood vessel with a device that can open up a stenosed vessel. I think they open up the device when they get to the point of stenosis and it presses back the obstruction. They can insert a "stent" which keeps the artery open.  They usually only do this if only one vessel has a problem. If multivessel, I guess they do bypass surgery.  

I'm sure a doctor could give a more sophisticated answer but hope this helps.  You can do an internet search and get good information on both

CHris
Avatar universal
thanks Chris for this information. Thanks for all the nice doctors and other patients for their support also.

I learn more here than from my so so cardio doc that is too busy to relieve my fears.

thanks again
Avatar universal
Dear Chris:
From our experience the stress tests are beneficial but an angiogram is probably the best method to determine any blockage.  My husband had all the stress tests which showed no problems but when we got the angiogram it showed blockage.  They have improved the procedure, so that while it is invasive they have come a long way in making it safer and easier on the patient.  Our cardiologist recommends one every 2 years for my husband and it has really been a life-saving and mind-relieving test for us.  Good luck.
Avatar universal
Hi Lorraine:

I guess an angiogram/cardiac cath is the only way to tell for sure if there is a blockage. I had a positive sestamibi scan but the arteries were normal, the opposite of your husband's case.  

Chris
Avatar universal
Thanks Lorraine for the information.

So, what I really need is an angiogram. Catherization
is just a term they use, i.e. meaning, the use of a catheter type device up the vein to view the heart heart arteries.

On Sunday, on an affliate TV station (CBS) they had a very good program on Women and their Hearts.
A Female cardiogist said that 46,000 more women die each year of Heart related diseases than men...mainly because many of the doctors still believe heart disease is a man's disease and often times a woman will display different symtoms than that of a man.

I believe the cardiolgist or one of them was affliated with Lenox Hill Hospital,wherever that is.

They also mentioned Cardia Rehab/fitness programs for women to get in shape. They also went on to say that we need to be more assertive? and ask for a complete cardiac workup if one feels something is not quite right.

In my case, this is easier said than done.  I have asked until I am blue in the face for a Stress Echo for my pains.  I read here that a Stress Echo is a very good test for women.  I had a plain echo and it was ok with just some slight thickening in various valves.  

My theory, if I were able to have a stress echo and this was positive or even questionable, then I could have the angiogram.  I certainly do not want heart Disease but I have a strong family history and this "not taking me seriously" is causing me to have an ulcer.  Peace of Mind is Priceless.  And, I have very good health Insurance to pay for this and do not have to get an approval.  Go figure!!!

Good Luck to your hubby.   I wish you both well.

PS..I believe they mentioned also on TV a site on the internet.

www.womens-health/com    I hope this is it.



Avatar universal
Hi!

They do the angiogram during the catheterization.

Couldn't you go to another cardiologist, or a regional center that is strong in cardiology, one that doesn't require a referral from your doctor?  I didn't have much trouble convincing them to do a sestamibi nuclear scan after a normal regular treadmill test. I don't think a stress echo is considered higher level than a sestamibi.

CHris
Avatar universal
my mother has atrial fibrilation.she has to have a hip replacement so they gave her thallium stress test and her heart beat slowed down one min in the test. now her heart dr will not  let have the hip replacement.he has her on coumadin and her heart beat is norm now .so where do we go from here.
Avatar universal
my mother has atrial fibrilation.she has to have a hip replacement so they gave her thallium stress test and her heart beat slowed down one min in the test. now her heart dr will not  let have the hip replacement.he has her on coumadin and her heart beat is norm now .so where do we go from here.
Avatar universal
my mother has atrial fibrilation.she has to have a hip replacement so they gave her thallium stress test and her heart beat slowed down one min in the test. now her heart dr will not  let have the hip replacement.he has her on coumadin and her heart beat is norm now .so where do we go from here.
Avatar universal
Is PET scan more accurate than angiogram?

Thanks.

Pat
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