what test to have

[zuber]

I have somewhat atypical chest symptoms..and some are typical....Basically my chest feels heavy all the time, but I also have attacks of nausea, lightheadedness, shortness of breath.    I'm only 30 years old though I am 50 pounds too fat and I'm an ex smoker.     My primary doctor did a plain stress test and resting echocardiogram, and a chest xray.  everything was normal.      I decided to go to a cardiologist on my own,  and he listened to me for about 4 minutes tops, barely checked my heart sounds, and instantly ordered a barrage of tests including Nuclear stress.    I was alot more interested in a cardiac CTA.    My question is basically this...If i can find someone to give me a cardiac CTA, would this really over ride the need for a nuclear stress in my case, in your opinion?  (from what i've read, CTA is an excellent test in atypical moderate risk people).    I just feel like the nuclear would be a waste of money, time, and radiation....  Are you feeling the same way I am?

[Douglas Bogart, MD]

A CT scan for calcium scoring would tell if you have plaque in your coronary arteries and would be less radiation than either of the tests--nuclear or CTA.  In the presence of a negative CT for Ca scoring and a negative stress test it would be very-very unlikely you have coronary artery disease.  PVC's are likely benign.

[zuber]

forgot to add i have new onset of PVC's with this