It sounds to me like he wants to discuss the issue with other colleagues to try and come to a conclusion. When you say "ct of chest" do you mean a CT Angiogram of the heart? If so, I assume this showed no blockages which is why the Nuclear scan is unbelievable?
Did you have chest pains during any of the tests?
He ran a series of test and told her to return for an Angiogram on the eye with the Fovea. Why is an Angiogram necessary for this type of problem and if the Fovea is still there, is there a cure for it? What can they do for her Fovea?
This discussion is related to <a href='http://www.medhelp.org/posts/show/224334'>Cataract Complication: Fovea leakage </a>.
An angiogram is not looking for electrical conduction problems like an EKG or holter monitor test. An angiogram rules out major blockages in the heart from plaque, etc.. Please ask your doctor for an event holter monitor that you can wear to check on the rhythm and electrical conduction of your heart.
People can have an reaction to the nuclear stress test. The test is not perfect. The only true test, which is a procedure, is the angiogram. My mom had the nuclear stress test and was told that it was not bad and a few months later she was totally plugged in two main arteries and about 99 percent plugged in the other. Have you had an echocardiogram yet? An echocardiogram can check the heart valves.
What test determined your EF factor? An Echo and stress test is pretty accurate, but a stress test is just an approximation. You will know a lot more about your heart health after the procedure, they will determine your EF factor during the Angiogram. Your heart arteries will be mapped, any abnormalities noted.
I have advanced CAD, and have for close to fifteen years. I wasn't very careful with my health until fifteen years ago.
have you accepted that a CT scan is as effective as the 'gold standard' catheter angiogram?
Which kind of CT please? The 64-slice? That's the latest I have heard of.
Towards the end of the test, I had heart attack symptoms ( which resolved with 3 squirts of nitro) and was sent to the hosp for an angiogram. Results of the angiogram were good , except for a 25% occlusion in a distal aeortic vessel on the back of my heart down by the apex. The Dr. said that my heart had "spasmed" during the stress test.
I had never had a problem with the treadmill test. With the med stress echo, my heart was beating faster than I think it ever has....
A nuclear stress test is about 85% accurate in finding CAD whereas a angiogram is 100% accurate. The angiogram also carries a 1 - 3% risk of complications, the most common risk, although very rare, is having an artery dissected during the procedure which results in emergency bypass surgery. Having said that, if I was told I needed one I would do it without hesitation. It is the gold standard of heart tests to determine if CAD is present.
A nuclear perfusion scan is useless unless it is backed up by an angiogram because collaterals could be feeding into tissue making it look healthy. As an example, my nuclear scan showed excellent results, but I had already had an angiogram. My angiogram showed a completely blocked LAD and a blockage in my LCx. My right artery was also totally blocked halfway down. Collateral vessels played a huge role. The amount of radiation used is not that high and risks are low.
A better test would be an echocardiogram to view the heart wall movement in realtime, and if there is an impairment that is significant the test will calculate an EF below normal. EF (ejection fraction) is the percent of blood pumped into circulation with each heartbeat.
It is difficult to say whether a cath angiogram (stent) is necessary without more information such as symptoms, other tests, etc... the stress test may have been included an echo?!
Hi Ken-thanks for responding-have you had an angiogram? My cardiologist put me on im (time released nitrates) in addition to the toprol xl (beta blocker) & said if the angina & SOB continued he wants to do an angiogram-if you did have an angiogram how did they decide when to do it?
Ed34's suggestion is spot on. An angiogram is the 'gold standard' to determine if a blockage exists, and if it can be fixed with a stent, or if bypass surgery is necessary, or if collateral arteries are developing naturally to 'light up' the area of the heart.
It will be interesting to hear what the angiogram finds, especially if his EF factor remains in the normal area.
A relative with similar sensitivities to particulate matter was unable to breathe in nuclear stress test and had to be given oxygen to rescue her. Also there is an issue with left basilar scarring. Cardiologist says nuclear stress test is not a very good test. Isn't there an alternative?
Sounds like this could be serious and I am wondering if this is an artery that has some buildup and is spasming. If so, he may need a stent to keep the artery opened. My friend had an artery spasming and she felt as though she was having a heart attack. Her back was shaking and she had extreme chest pain. She was taken to the ER by ambulance three different times and on three different occasions had angiograms.
I had an angiogram several years ago that showed mild amount of plaque. The cardiologist is indicating that based upon the stress test I may want to have another CT angiogram . He is not pressing however because I have no chest pain and he indicated the stress test results maybe related to the fact I have mycardial bridging. He has left it to me to decide to have another angiogram or just wait 6 months and redo thestress tests. Would appreciate advise.
I think a CT scan is far more accurate than an angiogram because it detects all vessels and it is much lower risk. The newer scanners are much quicker also, much quicker than an angiogram. My wife went for a follow up CT scan last week for her cancer, which usually took 30 minutes. She went in the room and just as I picked up a magazine and started to flick through the pages, she was back out. I thought it had been cancelled and I was amased to hear the scan was finished so quick.
Vessel occlusion can be identified by a CT angiogram or the invasive procedure by a cath angiogram. Neither test has 100% sensitivity rating, but quite good. Also an EKG can indicate ischemia (lack of blood flow to the heart) that may be due to a vessel blockage.
Usually, the tests aren't given unless there is chest pain, shortness of breath, etc., but if there is a family history of CAD and heart problems the testing for plague occluding vessels may be appropriate.
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