Cardiac Stress Tests...

I had a stress test sometime before my DS.  Wednesday, we had neck-to-hip CT scans looking for eveything that was wrong in those regions.  When they sit you down, they terrify you by essentially calling for the coroner.  Okay, not THAT bad...but it's like a list of, "You'd better do this stuff or else."  Of course, their natural reaction would be to blame a DS diet for all sorts of coronary issues.  (knowing that, I didn't answer the diet-related questions.)

So, can a cardiologist look at the old nuclear stress test done a few years ago and compare that to a brand new CT scan of those arteries?  Will there be a basis for comparison?  (Or will I need another stress test now and/or will I need to wait a year for a new CT scan?) 

See...what I'm thinking is that the calcification that is there now has no date on it.  I don't know if all of that stopped when I got the DS...or if some of it is still being laid down inside the arteries.  The best way would be to look at the arteries from six years ago and then from now...and see if they are MORE blocked--which would mean that I'm absorbing SOMETHING I shouldn't--or see if they are the same as pre-op--which would mean that we were able to arrest any additional damage.

Does anyone know if it is possible to compare the results of two different kinds of tests and arrive at a valid conclusion?

Yes.  In cardiac matter clinicians always look at previous ECG's and echocardiagrams to determine the state of your cardiac functioning.  A stress test is a reasonable marker but seriously only a dimension in the differential diagnosis.

Claudication of arteries is a gradual process.  You cholesterol levels are a strong indicator of how much occlusion you'll likely be laying down inside your arteries. Look if they thought you were a significant cardiac risk you'd have been sent for a angiogram.  The fact is that we allllllll will have some form of arterial sclerosis because you don't become a fat ******* from eating low fat yogurts forever.

So in short a differential diagnosis would be made on:
a) current symptoms or lack there of
b) recent and previous ecg's
c) old exercise stress test...did it provoke angina symptoms, syncope etc
d) blood calcium levels
e) any chronic disease processes in action

If a doctor is unable to use that breadth of information to determine your cardiac health without a CT scan then I despair for modern medicine in the US.  (us poor *******s in the NHS use clinical assessment in the absence of new machinery and have better statistics for diagnosis).

So I probably do not need another full cardiac stress test?  (Did I get that right?)  But I do want to do that thing where they figure out how big your cholesterol bits are.  

( articles.nydailynews.com/2011-08-25/entertainment/29943079_1 _heart-health-heart-attack-sanjay-gupta )


Same with the fatty liver thing?  Go by current blood work and not the old beat up liver because we don't know when it got that way?

The more current the blood work the better!

Yes they can compare the last Ct  with new one.. but ...... it would be better if they compared last angio to a current heart cath.

They will ALWAYS do a cath because CT"t are notorious for being false positive,,,then they want to visually see the vessels hence go to a heart cath.

Surprise,, insurance makes them do  the CT or Stress Test, ,but then do Heart Cath to clarify..

Other than that, yes do levels of blood for  comparison of enzymes.

I work with 18 different cardiologists and this seems to be the average method. lol
Deb

I don't think I understand well enough to make my inquiry intelligible.

I have a previous stress test and a current CT scan.  That's it as far as I know.   I know I've never had a heart cath and never had an angio.

Radiologly dude says, "you have calcification in the coronary arteries...blah, blah, blah. You need to go see your cardiologist." 

I'm just wondering if I have to take a whole ****load of tests, or if they can look at the old stress test and the current CT scan and tell me to relax or to pick out the flowers for my casket.

They can take a "**** load of tests" but many end up with the angio..., same as heart cath, different partsof country call it different names LOL

Like Kirmy said labs will show cholesterol and rest of  your levels butsince radiology dude said lots of calcifications,, thatmay be the next..

They can compare stress test to stress test, which leads( ekg tracins) you have any difference in specific parst of heart,
The calcifications are best seen with the Cardiac Catherization Angiogram,  Heart Cath, Angio..

At least you get to lay down on that one ! LOL  If the calcification warrents fixing, they put the stent in then,, Just make sure who ever you go to as a cardiologist, does his own interventions. Other wise you end up returning to do the stenting part, another trip to the cath room.

Pm me if you want to pick my brain,, I will give you my cell

I'm curious but in the states do they send asymptomatic patients for angios?

We only send those with angina, valve failure, pacing issues and collapsing pules postural drop etc.  Having calcification that is asymptomatic and HDL and LDL rates that are not problematic would mean medical and dietary management.  A cath is pretty invasive. 

Admittedly you see the works with a cath and get your occlusion gradients pretty spot on.  Just curious from a practitioner perspective. It must be cool to have such reactive services at your finger tips.  It takes AGES to get a patient seen as an out patient for angios unless it is critical.  We've had patients sit in our hospital awaiting transfer for two weeks!!! Got some awesome telemetry readings saved form that one LOL!

Hi Kirmy,

If they "fail" their test, stress, have EKG changes, our cardiologist can send them for an angio.

Probably why so many surgery patients end up with one here ! LOL
Yes they like it as they do see the stenosis, and calcification's, or thrombus an can immediately work on it if needed. We do single , biplane,, and digital rotation in our labs..

Some insurances state stress test first, some only elevated triponins. or some simple as short of breath... crazy

The only thing I agree is it is the best way to see inside the vessels , LOL

 We have one doc, at the drop of a "p or qrs change,, sends them for one !! He drives me nuts !!!
Bad thing he isn't too sure what he is looking at,  good thing we the team do...
Other good thing glad we are one of ten top heart hospitals in US.

I have a good friend in Norway and her medical system is the same,, As she is American she gets frustrated at the LOOONg wait times too !

Yeh the emphasis is medical management first before referral for angios and stenting. Obviously this isn't the case if your TropI or Trop T is elevated and you've had flipped t waves etc.

The wait is worse for us because we are a remote rural general and we need to get a slot in an area that looks after its own first. Makes life very ******g annoying.

You do good work.