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cardiolite stress test nuclear cta angiogram

I am only 31 but I went to a cardiologist about some shortness of breath issues, chest tightness/heaviness, lightheadedness, palpitations, and a couple incidents of left arm pain during exercise (that's what pushed me into seeing a cardiologist, the arm pain during exercise).   all those symptoms started together.    Today I had a resting echo, and Cardiolite stress test.   I got my pulse to 184, but I still only made it about 7 minutes on the treadmill.  My holter was negative (didn't have any palps on it, and may try a 30 day monitor soon.

Anyway, question is, with these symptoms....If the tests I had today turn out normal,  where might we go from here?   I had noticed he had me marked down as "urgent severity",   So do you believe that if these tests are normal then he will leave it at that,   or do you think I should get a CTA or something to further clarify? (if the cardiolite is normal that is..should I get a CTA then?).

1 other technical question,   I ate later than I should have.   I had a large meal 4 hours before the first scan, and 6 hours before the stress scan---Plus I drank a lot of water (just plain water) an hour before I arrived.   Will this affect the images in any serious way?

Thanks for your time
1 Responses
242509 tn?1196926198
In your age group, unless you have type 1 diabetes, the prevalence of obstructive coronary atherosclerosis is very low, and the stress test you have undergone is not 100% sensitive or specific in diagnosing coronary disease, so a positive test may not necessarily indicate coronary disease. The most concerning fact is that at your age you only were able to exercise to 7 mets: this is average for a 70 year old man, so you are either in very poor state of conditioning, very obese, have severe lung disease, or are the rare 31 year old man who indeed has obstructive atherosclerosis.
I would make sure that you have had these other issues addressed, either via a chest x- ray, echocardiogram or breathing studies. If all of these are negative then, irrespective of the cardiolyte findings,  I would favor going directly to a diagnostic left heart catheterization.
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