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re: ? for OT cardiologists and patients
Posted on 3/30/14 at 7:24 am to Cosmo
Posted on 3/30/14 at 7:24 am to Cosmo
People always get criticized for asking these questions on the OT, but there is always good and very beneficial information and discussion.
I learn a lot from reading the threads. Thanks to all if the medical professionals that take the time to respond in detail.
I learn a lot from reading the threads. Thanks to all if the medical professionals that take the time to respond in detail.
0
Posted on 3/30/14 at 7:28 am to Cosmo
Bottom line- chest pain go to ER. i go to ER with chest pain, usually the first one, sometimes I delay and its not good.
I have no family history, no smoke,no drink, no high bp, no etc etc. but cholesterol around 220, ldl above 100. and not overweight.
5 bypasses, 6 stents.
also, never had an abnormal EKG and troponins only elevate after the caths. and never an abnormal stress test.
I have no family history, no smoke,no drink, no high bp, no etc etc. but cholesterol around 220, ldl above 100. and not overweight.
5 bypasses, 6 stents.
also, never had an abnormal EKG and troponins only elevate after the caths. and never an abnormal stress test.
Posted on 3/30/14 at 7:28 am to Jim Rockford
quote:
How worrisome is an abnormal result on a nuclear stress test?
It's no big deal other then one feels like they died. Really, but last just for a few seconds. I had that done a few times and it is one feeling that sucks. It feels like your chest is going to exploded.
quote:
Patient is female (no pics), forties, in good health, non smoker, and physically active. Blood pressure and other tests are normal. TIA
So was I. In fact my BP was running at 100/60, were before I got sick, it was always 110/70.
What else you need to know? What is her EKG showing?
Posted on 3/30/14 at 7:33 am to fishfighter
AFAIK, EKG was normal. That's why there was no sense of urgency. I think this was just to rule something out. Maybe they're thinking it's a false positive and that's why they're not going straight to the cath, I dunno.
Posted on 3/30/14 at 7:39 am to Jim Rockford
I use Ochsner. Some of the best doctors there. Oh, they do have shitty ones too. I go to the transplant center once or twice a month. I get blood work twice a week now due to my numbers suck the big one.
I get blood work twice a week now due to my numbers suck the big one.
Posted on 3/30/14 at 7:49 am to Cosmo
quote:
False. A Calcium score CT is a screening test.
A coronary CTA does provide real info on stenosis. It generally will overestimate stenosis compared to a traditional cath though.
This.
An abnormal nuclear stress is going to show areas of abnormal perfusion and cardiac viability. In a otherwise healthy 40 year old (with a low calcium score), a CTA is an appropriate next step and will have a high negative predictive value. If the CTA is positive for a blockage than a Cath will likely be performed.
This post was edited on 3/30/14 at 7:50 am
Posted on 3/30/14 at 9:16 am to TypoKnig
Nuclear medicine stress tests can be tricky with young females, particularly if they have large breasts. Breast tissue can cause attenuation which can mimick a perfusion defect in the heart. Normally this will appear as a fixed defect but can appear as a reversible defect if large breasts are in different positions during the stress and rest images.
They may also have ordered the CT scan to look for pulmonary emboli, which can cause chest pain. Coronary artery CTAs are not very common but they can be helpful to evaluate for intermediate term risks in patients who have normal cardiac blood work (no concern for acute heart attack).
They may also have ordered the CT scan to look for pulmonary emboli, which can cause chest pain. Coronary artery CTAs are not very common but they can be helpful to evaluate for intermediate term risks in patients who have normal cardiac blood work (no concern for acute heart attack).
Posted on 3/30/14 at 9:21 am to Cosmo
quote:
A coronary CTA does provide real info on stenosis. It generally will overestimate stenosis compared to a traditional cath though.
Hence it's still a screening test. You cannot accurately assess blockage with it with 100% certainty. Now if it shows zero or little blockage, you're good. Abn CTA still = heart cath. So, technically it is diagnostic in someways, but still referred by cardiologist as a SCREENING test to see if a cath is needed.
Posted on 3/30/14 at 9:28 am to LSUMDinTN
quote:
They may also have ordered the CT scan to look for pulmonary emboli, which can cause chest pain. Coronary artery CTAs are not very common but they can be helpful to evaluate for intermediate term risks in patients who have normal cardiac blood work (no concern for acute heart attack).
Possibly, but why not start with the CTA. You may still need the cath and now you've tripled the exposure to radiation and contrast. Of course, it's hard to criticize without knowing all the details and thought process. But if it's purely for follow up of an abnormal stress test, do the cath. It's not as big of a deal as many will lead you to believe. shite if I ever have problems, frick a CTA or a st. I'm going straight to cath. Seen tooooooo many missed.
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