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Chemical Stress test vs Treadmill Test

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Old 02-21-2011, 07:51 AM   #1
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Chemical Stress test vs Treadmill Test

In August of 2009 I was hospitalized with Atria Fibrillation. I was put on flecainide and my sinus rhythm was restored within twenty minutes. This after receiving an echo cardiogram which showed my heart was "healthy".
Subsequently I was given a chemical stress test. ( the cardiologist only gives this type of test, says treadmill tests do not give proper results ).
The stress test showed that I might have a minor blockage in the lower part of my heart. My cardiologist suggested I undergo a catheterization, but because I have no medical coverage. He said it was not absolutely necessary, and we "could put it off " until I could find some insurance that would cover it. He said it just showed a very minor blockage, during the "rest period" of the test.
It has been almost two years, I still do not have insurance as it is beyond my financial means. I will have medicare in two more years.
My cardiologist is now harping on having the catheterization done. He is certified to only do chemical stress tests, and catheterizations. Which makes me suspicious. I asked him why, I wasn't given a treadmill test and he simply brushed me off with " they do not give me the results, I'm looking for". as an answer.
The catheterization if I had it now, would wipe out my meager savings. I have had no symptoms, or recurrence since going on the medication. I lead an active life, and exercise and go cycling regularly. I have had no symptoms such as shortness of breath, or pain. Each EKG I get, comes out normal. I was a gardener, and still do gardening work which can be quite strenuous. I have had no problems!
I would like to ask to have a treadmill test, before I would consent to having the catheterization ( which I really don't see the purpose ) just to see how I perform on that test. Am I acting foolish here?

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Old 02-21-2011, 03:39 PM   #2
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Re: Chemical Stress test vs Treadmill Test

I believe you are referring to a inverventional cardiologist (certified to do cath angiograms,angioplasty). An interventional cardiologists have been known to do an interventioanal process unnecessarily. For some insight:

A chemical stress test may be recommended for someone who does not have the capacity or at a risk with exertional stress test. No, you are no acting follishly. It may not be reasonable based on your information. Do you have any information from your echo test? What may be significance is the ejection fraction (EF), and normal would be 50 to 70%. This would represent the amount of blood pumped with each heartbeat.

Also, the echo would show wether there is any heart wall movement disorder. The heart wall movement would be the result of any "minor blockage". If there is some impairment usually the EF would be reduced as contractions may not be as strong
as it should be with no wall impairment (hypokinesis).

You may want to get a second opinion about whether or not additional testing is even necessary. If you don't have any symptoms, and a test indicates an area is getting reduced blood supply would not seem very compelling for cath angiogram.

I have a totally blocked LAD, and an ICX 70% blocked. Almost always there is no need to stent with a blockage at around 70%. Intervention, if there is angina (chest pain) not controlled with medication. Medication dilates the vessels and almost always prevents angina. Therapy with proper diet, exercise, medication to help keep the vessels from further calcification (CAD), and healthy lifestyle, etc. can prevent further ischemia (lack of blood flow) of the area identified.

My totally blocked LAD has/had developed a natural bypass (collateral vessels) and the 70% ICX for more than 7 years has not progressed and my condition remains stable.


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