Heart & Cardiology/abnormal stress test

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QUESTION: I have had issues with heart palps for a few years. I have seen several cardiologists and many tests done including a nuclear stress test about 2 years ago which was normal. An event monitor showed PACs. I had a stress test last week that was abnormal and my dr wants to follow up with a stress echo on June 10 but I have anxiety issues and the wait is killing me. I saw another cardiologist today for another opinion and he said either a stress echo needs to be done or a nuclear stress.  He is leaving the decision to me. I have no idea what to do. I just want something done. Thoughts?

ANSWER: Hello Noreen,

Either stress echo or stress nuclear is fine.

The indication for intervention with balloon angioplasty or surgical bypass is pain you don't want to put up with.  Medical treatment with aspirin, a statin and a beta blocker is as effective in preventing heart attack or cardiac death as is angioplasty or CABG.  Please ask the cardiologist why they want a fancy stress test.  Are they considering angioplasty or CABG?  I don't think you need intervention unless you have chest discomfort.

Please write back if this note doesn’t answer all your questions.

David Richardson


---------- FOLLOW-UP ----------

QUESTION: I do have cheat discomfort. Neither doctor mentioned either of those procedures. Just the need for another stress test. I am already on Metoprolol 50mg twice a day and aspirin. Now you really have me worried! Which of the stress tests should I have done?

Answer
Either one if fine.  Personally, I can see radioisotope scans better, but either test will do the job.  Please let me know what you find out, and tell me more about your chest discomfort.  Only with exercise?  Where in chest?  Is it modified by pressing on the uncomfortable area?

Heart & Cardiology

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David Richardson

Expertise

Adult heart function and disease. Not very good about children lesss than 12. Hypertension is o.k. Heart rhythm a special interest.

Experience

Certified in cardiology by the American Board of Internal Medicine. Was chairman of division of cardiology at the Medical College of Virginia. Am now mostly retired.

Organizations
Fellow of American Heart Association and American College of Cardiology and member of American Physiological Society..

Publications
Circulation, American Heart Journal, Hypertension.

Education/Credentials
M.D. from Harvard Medical School. Residency training at Yale Uhniversity School of Medicine and Medical College of Virginia.

Awards and Honors
Gold Heartt Award from American Heart Association in 1995.

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