Whether to have a heart cath?

[Brenda]

My husband, had a 9by-pass surgery in 1-99.  He has continued to have problems.  This summer he had alot of chest pain.  He had the stress tests done.  The first one on the treadmill wasn't conculsive.  So the second test was done.  The resting test the person taking the test said his heart beat went down and wasn't pumping enough blood through the heart.  The doctor said the second test was okay.  His doctor seems to say, he doesn't believe he has a problem (but he has been wrong).  He said the person taking the test should have kept his mouth shut, that his job was to only take the test.  He also said when the second test showed nothing that just meant the resting part of the test was basically incorrect.  We decided not to do anything, yet he still has chest pains.  Especially during high stress.  He had to go back to his primary doctor to have his prescription renewed for Liptor.  Now my husband's primary doctor thinks he should have the heart cath.  We are unsure what to do.  Should we go ahead with the heart cath?  I understand that would tell all.  He was also diagnosed with having a stroke during surgery, because he has had dizziness since the surgery. (had a MRI).  His heart doctor also seems to think he didn't have a stroke but gives no other reason for his dizziness.  We feel his heart doctors aren't trying to help him.  They seem to think its all in his head.

[Brenda Fowler]

Thank you for answering my question.  Although we still are unsure what course to take.  My husbands lack of blood flow occured during the resting  stage of the test.

Also, after he had is surgery his heartbeat so strongly, that it was hard to sleep next to him, and I could see it across the room.  That has gone away.  Is it normal to have the heartbeat lessen after your body has "healed"?

[Cleveland Clinic, MD]

Dear Brenda,
The type of test to choose to evaluate chest pain is not always a straightforward decision.  It sounds like your husband had a nuclear stress test that showed scar in some areas consistent with previous heart attack (no perfusion during rest) but no ischemia during exercise (lack of blood flow due to coronary blockages).  The accuracy of a nuclear test is high (in the 90% range) but it can sometimes be wrong.  If your doctors still suspect blockages then proceeding to a cath is reasonable. Hope this helps.