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Old 05-19-2007, 07:34 PM   #1
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Test Frequency

Hi..I had an echocardiogram, nuclear stress test and EKG a little over a year ago, I am wondering how frequently those tests should be run? Also, for a woman, how accurate are they? I have been told that the echo and the nuclear stress tests are the best and most accurate for women. Anyway, just wondering....
Thanks for everyones help!
Crazy

 
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Old 05-19-2007, 08:18 PM   #2
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Re: Test Frequency

Crazy,

I just asked my cardiologist this question in April. I am a 49 year old male and I had complete cardiac workups in Feb 05 and Mar 06. They included echos, nuclear stress tests and bloodwork, all normal. The only reason I had the one in Mar 06 is because I was starting to see a new cardiologist and she wanted her own set of tests for a baseline. When I asked in April during my annual physical if we were going to repeat the tests she said no. Generally she only repeats these when your symptoms change or if you have strong risk factors, most importantly a strong family history or if you are a smoker then maybe every year or two.

As far as accuracy, I know women are more likely to get a false positive on the nuclear stress test, that is why you want to be careful how often you repeat these tests as the risk of a false positive goes up each time you are tested which would lead to more invasive tests with a higher risk. Also, when you talk about the accuracy of the stress test, the main thing to know is that it has a very high negative predictive value. With normal results, the chance of a cardiac event each year for the next 10 years is less than 1% ( I believe the actual number is .62% per year). I believe that is the same for both men and women but maybe someone else can comment on that.

Good Luck!

Tony

Last edited by Toneman; 05-19-2007 at 08:21 PM.

 
Old 05-20-2007, 07:04 AM   #3
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Lenin HB UserLenin HB UserLenin HB UserLenin HB UserLenin HB User
Re: Test Frequency

If he results of the tests were negative, I would think something like every three years is good enough for an echo or a nuclear stress test is good enough.
More often with symptoms.

Usually an EKG with every physical is done...probably overtesting. (My PCP has a new machine so he hauls it out at every opportunity, almost every vistit, then shakes his head knowingly at the pretty squiggly lines." )

Often what your insurance company will bear will limit the frequency. I am pretty sure that a symptomless person billing a nuclear test every year will wind up with denials from his insurance company...probably with good reason.

 
Old 05-20-2007, 07:06 PM   #4
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Re: Test Frequency

Thanks Guys! I had all of those tests in Mar 06 and all were normal. My cardiologist told me that he felt as though my problems were related to GERD/LPR. I am a 45 year old female and slightly overweight, was just diagnosed with borderline high blood pressure in Feb 07 (which my doctor feels was caused by stress). I guess I just am concerned, it is hard not to be with all of the advertising going on about womens heart health and heart attacks.
Do either of you know about the valdity or accuracy of a H-CRP test. I was told that since I have GERD and have been on birth control pills that the numbers would be skewed high and I have had doctors say that the test is not really as valid as previously noted.

Thanks Again for your input!
Crazy

 
Old 05-21-2007, 11:02 AM   #5
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Re: Test Frequency

Crazy,
C-reactive protein is a marker for inflammation. If high, it often signals an arterial inflammation which may be a precursor to, or accompany heart disease...it should then be considered another risk factor for heart disease.

(The H- part means high sensitivity.)

HAVE the test the next visit, along with homocysteine and Lp(a) <lipoprotein-A.>

Last edited by Lenin; 05-21-2007 at 11:03 AM.

 
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