Medical advice from Drs. Marc Siegel and David Samadi
And back now sunday house call in our segment should i worry a weekly segment oh she talked about everything that worries us one viewer writes i’m a 52 year old woman never smoked i’m in great shape but have been scheduled for a thallium stress test should i worry dr. siegel why do you think her doctor suggested this we don’t have enough information but i will say
This because we don’t know what else she has if she has a family history of heart disease if she says she’s not having any symptoms at all presumably she’s had no chest pain she has high blood pressure high cholesterol if she exercises a lot and is about to do a marathon and wants to know if she is a risk those are reasons to consider it but consider this eric that
What’s called the pretest probability with a stress test a thallium which is much better what is that okay what a stress test is is you walk someone on or run them on a treadmill and you look to see what happens you simulate the what’s called increased workload of the heart and when the heart is under stress you look to see if there’s an example of some narrowing
That’s going on but it would have to be more than 70% of the coronary arteries being narrowed before it would come out on a stress test 70% why am i saying that because you could have disease to your arteries of the heart and a stress test wouldn’t show it it’s got to be really narrow before it comes out it’s also overdone in some people not everybody over 50
Should have a stress test but i told you the reasons if she has a risk a real risk then i might or diabetes is another risk factor then i might want to do it knowing that the pretest probability the chances of her having a problem is only 80 to 90% that a stress test will pick it up not a hundred percent stress tests missed the problem and then they’ll sometimes
Tell you you have it what should you do to find out if you have car you know a narrowing of the arteries well there’s other things you can do besides the stress test we talked about calcium scoring tests to see whether you have a tendency towards it we talked about an angiogram or a ct angiogram a cat-scan angiogram to look for narrowing but what i like about a
Stress test one more point what i like about a stress test is it’s a test that that examines function in other words it’s practical it’s saying hey before you run a marathon we’re going to do it under under circumstances where we can control it and see if you have the problem so that’s why i like about it you know i want to play you know obviously he deals with
This a lot more and there are a lot of cardiologists out there it’s good to know what is the indication for stress test and i want to play a little devil’s advocate just to you know for education purposes if you have high cholesterol high blood pressure should you go for stresses and based on what i understand the answer is is no like when i read this email right
Now she’s she doesn’t smoke she exercises in great shape she’s in great shape she’s only 53 year old and if there is no chest pain if there’s no i enjoy now there’s no real family history i don’t see any reason why first of all we’re getting this stress test our stress test being overdone in this country are we getting too many tests that’s what i think we need to
Respond to that but what happens with stress test is when you put them on treadmill and you look at their blood pressure you look at their ekgs if there are abnormalities that’s when eric they will go for angiogram to find out the whole purpose of this is to find out if there are any blockage in your coronary artery disease which is the blood flow to your heart
And if you know i don’t see any reason in this particular patient but let me let me address that what i should say is that the more risk factors you have the more of a chance you would do this and also if you have ekg abnormalities okay if somebody is doing a screening so no woman comes to see me she has high cholesterol diabetes high blood pressure i agree with
David i would not do is just would you do a g first then absolutely that the order and i see something on the ekg then i might go for the string and what’s that thallium test is that different than a regular what what they do is they give you this thallium and then they take your scanner and the picture of your heart and then they start like having this treadmill
They start uploading the amount of the let your heart is working and look at your heart rate look at your ekg changes look at your blood pressure and see if there is any kind of blockage if you have blockage you’re going to have abnormalities once you go to the higher heart rate the thallium is the dye use you put in and it doesn’t get picked up by the arteries
That are blocked okay okay i know advice is always good advice you know that she wrote in to the doctors if you have a question you do that to the email is house call at foxnews.com and they could get to a lot of the questions of our viewers who write in we thank you for writing in and please keep your questions coming to the doctors because they have great answers
Transcribed from video
Doctor scheduled a thallium stress test: Should I Worry? By Fox News
