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Dr - 1. I Am 48 Years Old & Have
Question: Dr -
1. I am 48 years old & have a history of heart disease/heart attack/bypass surgery in my family
2. approximately 5 year ago I underwent several cardiac tests including Holter monitor, Echocardiogram, Nuclear Treadmill Stress Test. The results were fine. My current LDL = 120 & other blood work is normal.
3. Last week I was experiencing upper back spasms. I also experienced radiating pain in my left pectoral/chest & left arm area. I went to the emergency room & they conducted blood work & explained that my symptoms were not cardiac but rather they were musculoskeletal.
4. The next night I awoke with severe pain in left arm & left pectoral/chest area. I spoke to another cardiologist & explained the situation & he stated that these symptoms were not cardiac but rather musculoskeletal.
5. However, my cardiologist wants me to undergo another Nuclear Treadmill Stress Test & Calcium Chest CT Study.
6. I am concerned about the radiation exposure. Do you think I should undergo these tests? How much radiation will I be exposed to in these tests? How harmful is this radiation?
Thank you.
1. I am 48 years old & have a history of heart disease/heart attack/bypass surgery in my family
2. approximately 5 year ago I underwent several cardiac tests including Holter monitor, Echocardiogram, Nuclear Treadmill Stress Test. The results were fine. My current LDL = 120 & other blood work is normal.
3. Last week I was experiencing upper back spasms. I also experienced radiating pain in my left pectoral/chest & left arm area. I went to the emergency room & they conducted blood work & explained that my symptoms were not cardiac but rather they were musculoskeletal.
4. The next night I awoke with severe pain in left arm & left pectoral/chest area. I spoke to another cardiologist & explained the situation & he stated that these symptoms were not cardiac but rather musculoskeletal.
5. However, my cardiologist wants me to undergo another Nuclear Treadmill Stress Test & Calcium Chest CT Study.
6. I am concerned about the radiation exposure. Do you think I should undergo these tests? How much radiation will I be exposed to in these tests? How harmful is this radiation?
Thank you.
Brief Answer:
Yes it should be done
Detailed Answer:
Hello
I can understand your concern and I would like to tell you that as there is a strong family history of heart disease and currently you are experiencing atypical symptoms so this scenario makes cardiac evaluation very important.
Now as the cardiac tests were done 5 years back so there is a need for evaluation now.
Yes you should undergo the tests advised by your doctor to rule out the underlying possibilities of coronary artery disease.
Regarding radiation the amount of radiation is quite higher than the radiation recievied in a normal X-ray but even then it is within the recommendations that a human body can tolerate. So don’t worry for that.
Here evaluation is more important than radiation.
Kindly get the tests done as advised by your doctor.
Kind Regards
Dr Bhanu Partap
Yes it should be done
Detailed Answer:
Hello
I can understand your concern and I would like to tell you that as there is a strong family history of heart disease and currently you are experiencing atypical symptoms so this scenario makes cardiac evaluation very important.
Now as the cardiac tests were done 5 years back so there is a need for evaluation now.
Yes you should undergo the tests advised by your doctor to rule out the underlying possibilities of coronary artery disease.
Regarding radiation the amount of radiation is quite higher than the radiation recievied in a normal X-ray but even then it is within the recommendations that a human body can tolerate. So don’t worry for that.
Here evaluation is more important than radiation.
Kindly get the tests done as advised by your doctor.
Kind Regards
Dr Bhanu Partap
Above answer was peer-reviewed by :
Dr. Nagamani Ng
Dr- I have modified some of the information I sent you last time:
1. Here is the information that you requested. I found out that my doctor has ordered a coronary computed tomography angiogram CTA. It's my understanding that this test will expose me to approximately 10 mSV. Is this correct?
2. My doctor also ordered a nuclear treadmill stress test. In This test they use a substance called Technetium/SESTAMIBI. It's my understanding that this test will expose me to approximately 20 mSV's. This is because the substance is injected into my bloodstream on two separate occasions. The first time I will receive this substance is at rest the second time I will receive it when I am on the treadmill. Is this correct?
3. Based upon this new information doctor, what type of risks will I be exposed to in your opinion? Will these test increase my likelihood of developing cancer in the future? Do you think it is worth the risk?
4. You stated - "there is a strong family history of heart disease and currently you are experiencing atypical symptoms so this scenario makes cardiac evaluation very important" ? What do you mean by atypical symptoms dr?
1. Here is the information that you requested. I found out that my doctor has ordered a coronary computed tomography angiogram CTA. It's my understanding that this test will expose me to approximately 10 mSV. Is this correct?
2. My doctor also ordered a nuclear treadmill stress test. In This test they use a substance called Technetium/SESTAMIBI. It's my understanding that this test will expose me to approximately 20 mSV's. This is because the substance is injected into my bloodstream on two separate occasions. The first time I will receive this substance is at rest the second time I will receive it when I am on the treadmill. Is this correct?
3. Based upon this new information doctor, what type of risks will I be exposed to in your opinion? Will these test increase my likelihood of developing cancer in the future? Do you think it is worth the risk?
4. You stated - "there is a strong family history of heart disease and currently you are experiencing atypical symptoms so this scenario makes cardiac evaluation very important" ? What do you mean by atypical symptoms dr?
Brief Answer:
Hello again
Detailed Answer:
I can very well understand your concern for radiation and stuff, but rest assured the amount of radiation which a patient receive from these tests are well within the normal tolerable range for human body.
As these tests are not done on frequent basis so the chances of developing any sort of cancer due to these tests are highly unlikely.
It’s important to get the tests done because coronary artery disease if significant needs to be addressed timely as there is always a potential life risk if left untreated.
By atypical I means they are not very strongly suggestive that your symptoms are only because of underlying cardiac pathology.
I hope this information will answer your query.
Kind Regards
Dr Bhanu Partap
Hello again
Detailed Answer:
I can very well understand your concern for radiation and stuff, but rest assured the amount of radiation which a patient receive from these tests are well within the normal tolerable range for human body.
As these tests are not done on frequent basis so the chances of developing any sort of cancer due to these tests are highly unlikely.
It’s important to get the tests done because coronary artery disease if significant needs to be addressed timely as there is always a potential life risk if left untreated.
By atypical I means they are not very strongly suggestive that your symptoms are only because of underlying cardiac pathology.
I hope this information will answer your query.
Kind Regards
Dr Bhanu Partap
Above answer was peer-reviewed by :
Dr. Nagamani Ng
Dr-
1. Out of the two tests my doctor ordered - the coronary computed tomography angiogram CTA & the nuclear treadmill stress test - which one do you think is most important? which one is most illustrative of heart disease? What exactly do each of these two tests indicate?
2. I am considering completing the most important test first - and then if there's a problem - I will complete the second test, to confirm the diagnosis
3. If there is no problem indicated in the first test - the most important of these two tests - then I may not complete the second one, in order to limit my exposure to radiation
Thank you.
1. Out of the two tests my doctor ordered - the coronary computed tomography angiogram CTA & the nuclear treadmill stress test - which one do you think is most important? which one is most illustrative of heart disease? What exactly do each of these two tests indicate?
2. I am considering completing the most important test first - and then if there's a problem - I will complete the second test, to confirm the diagnosis
3. If there is no problem indicated in the first test - the most important of these two tests - then I may not complete the second one, in order to limit my exposure to radiation
Thank you.
Brief Answer:
Hello again
Detailed Answer:
If you want to take just one out of the two tests then it’s advisable that you should get a CT Angiography done as it will provide information regarding any sort of blockage that might be developing inside the coronary vessels.
Kind Regards
Dr Bhanu Partap
Hello again
Detailed Answer:
If you want to take just one out of the two tests then it’s advisable that you should get a CT Angiography done as it will provide information regarding any sort of blockage that might be developing inside the coronary vessels.
Kind Regards
Dr Bhanu Partap
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Nagamani Ng
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