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What Do Normal ECG Report Along With Positive Stress Test Indicate?
Question: I went to a heart doctor because my ekg was abnormal. I had a echo and a nuclear stress test. Doctor told me the echo was good muscles are good no problem. Stress showed abnormal. Shows a blockage. I asked the heart doctor and my primary how much blockage then told me they didn't know . Then I asked what arteries were blocked they couldn't tell me this. But my primary did tell me the front of my heart was excellent. Then she said that a stress test is not a 100% it could be false negative or false positive. My question by looking at the stress test they could not tell me the blockage or what artery? Now I'm going for a cta scan and I'm scared to death I want results and not going for test after test. If there is a bockage can I be put on medications. I read the first thing my heart doctor will say stent which some doctors don't agree.
Please help me to ease my mind I know some people are allergic to the XXXXXXX for a cta.
Please help me to ease my mind I know some people are allergic to the XXXXXXX for a cta.
Brief Answer:
CT angiography is not as dangerous, serious side effects rates are rare
Detailed Answer:
Dear Mrs,
In order not to expose all patients to complicated and expensive examinations, we have step by step strategy in cardiology nowadays.
At first ECG is done, as in your case, if there is any abnormality, echocardiography and stress test are performed. And depending on results we can go further to perform more examinations, or stop, if there is no abnormality.
In your case you have normal echocardiography, which is very good. There are minor changes in ECG and you have positive stress test, which indicates that some part of your heart muscle don't have adequate blood supply during physical activity. It is usually caused by blockages in the coronary arteries (heart arteries). Usually we can't tell in what specific artery the blockage is located, but we can suppose what artery can cause changes during stress test. The exact answer will be only after coronary angiography or CT angiography.
Actually in your case I would prefer coronary angiography, as stress tests have quite high specificity. And in case CT angiography is positive there will be a need for angiography and angiograplasty (stent). So, I would go directly for angiography.
About safety, as you know, every procedure has side effects. Even stress test has very low rate of mortality.
With newer contrast agents, we have very low rates of any side effects. Allergic reactions become less and less, and death is very rare. Usually we have minor side effects, which are handled easily.
Hope I could help you
Wishing you good health
In case of further questions don't hesitate to ask
Regards,
CT angiography is not as dangerous, serious side effects rates are rare
Detailed Answer:
Dear Mrs,
In order not to expose all patients to complicated and expensive examinations, we have step by step strategy in cardiology nowadays.
At first ECG is done, as in your case, if there is any abnormality, echocardiography and stress test are performed. And depending on results we can go further to perform more examinations, or stop, if there is no abnormality.
In your case you have normal echocardiography, which is very good. There are minor changes in ECG and you have positive stress test, which indicates that some part of your heart muscle don't have adequate blood supply during physical activity. It is usually caused by blockages in the coronary arteries (heart arteries). Usually we can't tell in what specific artery the blockage is located, but we can suppose what artery can cause changes during stress test. The exact answer will be only after coronary angiography or CT angiography.
Actually in your case I would prefer coronary angiography, as stress tests have quite high specificity. And in case CT angiography is positive there will be a need for angiography and angiograplasty (stent). So, I would go directly for angiography.
About safety, as you know, every procedure has side effects. Even stress test has very low rate of mortality.
With newer contrast agents, we have very low rates of any side effects. Allergic reactions become less and less, and death is very rare. Usually we have minor side effects, which are handled easily.
Hope I could help you
Wishing you good health
In case of further questions don't hesitate to ask
Regards,
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Why can't Doctor start with medication before stent. I did read that most doctors go for the stent instead of other means. Also read that a lot of doctors prefer medication first.
I chose the cta because it was less invasive and the doctor recommended it...
I chose the cta because it was less invasive and the doctor recommended it...
Brief Answer:
Welcome back
Detailed Answer:
Dear Mrs,
Medications should be started anyway. But coronary arteries should be evaluated. In case there are serious blockages, such as left main or dominant LAD, they should be stented. If there is a stable blockage and a stable disease, conservative treatment with medications can be the choice.
Regards,
Welcome back
Detailed Answer:
Dear Mrs,
Medications should be started anyway. But coronary arteries should be evaluated. In case there are serious blockages, such as left main or dominant LAD, they should be stented. If there is a stable blockage and a stable disease, conservative treatment with medications can be the choice.
Regards,
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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