nuclear stress test vs stress echo

well my cardiologist keeps insisting I need a nuclear stress test and ignored me when I said I would prefer stress echo because I don't want radioactive stuff in my body. He wants me to have it because ultrasound showed some blockage in my neck arteries so I assume he thinks I may have other blockage elsewhere (in the meantime am following Dr Esseltyn's protocol to get rid of or prevent more blockage). So would the stress echo do as good a job as the nuclear test?



Edited 2 time(s). Last edit at 05/06/2020 05:19AM by anneh.

I'm not a doctor but I think your doctor is right. If your doc was looking for problems with your heart, a stress-echo would make more sense, but he's looking at your carotids in your neck. A stress-echo isn't going to tell him what he needs to know.

What about a CIMT (carotid intima media test) with an ultrasound?

Have you had a CAC ?

thnx I am pretty sure that is what I had done on my neck that showed blockage, I assume he wants to test other areas now

no that wasn't suggested, certainly sounds better than nuclear test =:0

I think second guessing your doctor's diagnostic methods when we don't even know exactly what he's looking for is more than a bit presumptuous. You can always refuse any test, and that will force him to choose something else or skip the testing entirely. But if I had occlusions in my carotids I wouldn't do that. I would imagine his concern is that if you've got occlusions in big arteries like your carotids that you could have more serious occlusions in smaller arteries supplying your heart. I'd worry more about those than the test.

thnx for your input, however now very frightened and panicky that they will find something awful as you imply

I very much doubt they're going to find anything awful. If there was something awful to be found, you'd most likely have symptoms.

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anneh
well my cardiologist keeps insisting I need a nuclear stress test and ignored me when I said I would prefer stress echo because I don't want radioactive stuff in my body. He wants me to have it because ultrasound showed some blockage in my neck arteries so I assume he thinks I may have other blockage elsewhere (in the meantime am following Dr Esseltyn's protocol to get rid of or prevent more blockage). So would the stress echo do as good a job as the nuclear test?

If he wants to investigate your carotids further, I'd guess that you would need to do the nuclear test. But if he only wants to investigate any possible blockages in other arteries, an angiogram is another option. I had to have one recently and it was quick. Also, if they did find a blockage, they could insert a stent at the same time.

Hi. I’m an Afibber and former nuclear medicine technologist and have performed many stress/nuclear heart studies. Typically referred to as a SPECT scan. This study is for the sole purpose of looking at the perfusion of blood to your heart muscle. It will determine if you’ve had an infarct or if you have any ischemia. It tells you nothing per se about your carotid arteries. If you have some blockage in your carotids I’m assuming your cardiologist wants to do the SPECT study to rule out blockage in your coronary arteries. The typical protocol is to inject you with 20-25mci of technetium 99 sestamibi (Cardiolite) and image your heart while at rest. Then have you come back the next day and put you on the treadmill while hooked up to an ekg and stress you to 85% of your maximum heart rate for your age and inject the second dose of the same radionuclide at maximum exercise then image your heart again. Imaging does not emit radiation, but detects the radionucllide that was injected. Images at rest are compared to those at stress to see if there are any perfusion defects. It’s a painless test except for running you as much as they can and the radiation dose is safe and low. Your dose of radiation is about equal to that of a cross country flight at 30,000 feet. The radionuclide has a short 6 hour 1/2 life and much of it is peed out the first 12 hours. I just had one if these studies last week and learned I have no CAD which is reassuring to know. I’d encourage you to get the test.
Paul



Edited 1 time(s). Last edit at 05/15/2020 11:33AM by Pokey.