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Relative merits or preference of an angiograph versus stress MPI - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Excellent Posted in: Hypertension and Heart Disease
Answered by

General & Family Physician
Practicing since : 2005
Answered : 2407 Questions
User :   I needed an opinion on the relative merits / preference of an angiograph vs a Stress MPI
Doctor :   hi
Doctor :   Dr.XXX here.
User :   Hi, I needed an opinion on the relative merits / preference of an angiograph vs a Stress MPI
Doctor :   what symptoms do you have at present?
Doctor :   for what purpose have they been advised to you?
User :   This is actually for my mother. She has been through an Echo and a TMT and 2 different doctors have advised the 2 different tests
Doctor :   ok
Doctor :   what were the ECHO and TMT test results?
User :   She is diabetics, has hypertension and asthma - she was to go through a hernia operation and as part of the pre-op checks the cardiologist picked up something in the echo and tmt tests
Doctor :   could you send me the copy of the ECHO and the TMT test on YYYY@YYYY ?
Doctor :   if not type the re[port/impression here
User :   The TMT tests read - Moderate Effort Tolerance, Normal HR and BP response, Baseline ECG Shows DT Depression, Horizontal ST Segment depression noted in early recovery, no Angina / Arrhythmias **** TMT positive for Inducible ischemia***
Doctor :   ok
User :   I could get the reports scanned and sent through to you if that would be preferable
User :   given what i have typed above and the patient history what would you recommend as next steps
Doctor :   given the report you have typed here, i would recommend that she gets the Stress MPI test first
User :   on the Echo the impression reads are: Concentric LVH / Trivial MR / Trivial AR / Trivial TR , Mild PAH / LV daistolic dysfunction Grade II / Normal LV systolic function
User :   the impression i was given by the doctor recommending the angiography was that the stress MPI is not conclusive and definitive and the only way to get a clear picture would be angiography where as the other doctor preferred a sequential approach - is that in line with your thinking
Doctor :   she should get the stress MPI test done first, it it picks up abnormality suggesting obstruction of blood vessels supplying the heart, then angiography would be needed
User :   Thank you for the same doctor..
Doctor :   have you followed what I have said?
User :   Yes - will do stress MPI first and then based on results doctors will advise angio or not
Doctor :   is there anything else I can help you with?
User :   Thanks - doctor , will reach out again / if anything is required
Doctor :   sure. thanks for consulting me. bye for now
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