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Offline spaceplus

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Nuclear Stress Test
« on: May 04, 2014, 08:05:06 PM »
Greetings, everyone. 35-year-old longtime cardiophobe/panic-sufferer here, new poster.

I was admitted to the hospital last week during a panic attack with high heart rate and some 'skipped beats'. I  received a chest x-ray, an EKG, an Echocardiogram, 24-hour EKG monitoring, and full blood work.

The cardiologist said all the tests were OK. He discharged me and scheduled a nuclear stress test this Monday.

I am concerned about the test.  Specifically, I am concerned about the fairly substantial amount of radiation that one is exposed to during the Nuclear Stress Test.

I am conflicted. On one hand, I want desperately to have the test to achieve peace of mind. I know from my reading that EKG and Echocardiogram test results are of limited value in terms of definitively ruling out heart disease. The nuclear stress test is significantly more conclusive.

On the other hand, I don't know if I need the test. I have had 'tachycardia' (which means high heart rate) since i was a teenager, and I take a beta blocker to lower the heart rate. In the last few years, I have also experienced some palpitations and 'skipped beats,' which my Primary Doctor told me are benign. know I am a lifelong hypochondriac who has been admitted to the ER 4-5 times since age 15 during  panic attacks.

This new cardiologist was rather casual in recommending the Nuclear Stress Test. And I know that doctors are notorious for ordering all kinds of tests that may be unnecessary.

If it were not for the issue of radiation exposure, I would gladly have the test. But as a hypochondriac, trading obsession with heart disease  for obsession with cancer is a dilemma.

What do you guys think?
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Offline Walnut

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Re: Nuclear Stress Test
« Reply #1 on: May 04, 2014, 09:11:02 PM »
Sorry your having such a hard time. Ive had chest pains since I was a teen. They got worse after I got electrocuted when I was 14 or 15. Im 33 now. In my 20s I had alot of heart fears too. Several E.R. visits. 2 ekg's and I just couldnt accept that something that my heart was fine. Ive had palpitations and weird beats and still do. Im 6 ft 4. 210 lbs. my blood pressure is normally 113/65 with a heart rate in  the 50s to 60s. My doc sent me for a nuclear stress test and everything came out fine. It wasnt until years later that I learned about radiation exposure. In my early 20s to late 20s I had 2 abdominal ct scans and the nuclear stress test. My fear went wild thinking id die young of cancer. Well, Im 33 now and I dont have it yet. I hope that I never do but I read alot on it at one time and it seems it just increases the risk of getting cancer some not actually causing cancer. Well I should say "theoretically increases the risk"
I found this article for you that I think you will enjoy. It should ease your fears about radiation and cancer.
https://hps.org/publicinformation/ate/q10056.html
The article explains how there is a very small risk but a huge benefit of the test. What if the tests shows something that can be fixed easily but MAY SLIGHTLY increase your risk for cancer? I think I would take the risk. The benefit is greater. I just dont think you should fear the radiation. Check out the article and I think it will ease your mind some. I hope you start to feel better soon my friend.
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I am horrible about forgetting which threads I have replied to. If you dont get a reply back from me feel free to message me.

My screen name used to be "Nutty" Ive been a member since 2008. I forgot what email I used back then so I cant login to my old name.

Offline Brick5711

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Re: Nuclear Stress Test
« Reply #2 on: May 04, 2014, 09:33:50 PM »
An echo is very significant in ruling out heart disease. I see a cardiologist every six months and have had two echos done. I am 23. I would not get the NST.
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Offline patmob

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Re: Nuclear Stress Test
« Reply #3 on: May 05, 2014, 06:11:13 AM »
Why you say that a nuclear stress test has "fairly significant" radiation - what do you mean?  I know they inject a radioactive dye, but what is the level of the dye and how does that compare to other things? 
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Offline AOKAY

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Re: Nuclear Stress Test
« Reply #4 on: May 05, 2014, 12:06:06 PM »
Sorry about your heart worries.  I can empathize.

My Mom died of sudden cardiac death at age 59.  When I had my annual physical at age 50 my primary care doctor recommended a nuclear stress test and I did not protest.  Frankly, I did not take the radiation exposure into account when I agreed to the test, but should have.  I had previously been examined by a cardiologist who did the usual EKG, echocardiogram and 24 hour monitor and said all was clear.  That should have calmed my mind.  But, I went ahead with the nuclear stress test.  I remember sitting in the waiting area with a bunch of much older individuals, most of whom seemed rather frail or ill.  When it was my turn I got on the treadmill and the cardiologist supervising the test asked me about 5 minutes into the test why I was there.  I told him about my family history and he said everything looked fine and seemed to imply the test was a waste of his and my time, particularly since I had cleared all the previous heart tests.

As a patient with Crohns disease, I was exposed to a considerable amount of radiation in my teens and early 20's, as that was the only way they could monitor inflammatory bowel disease before the invention of scopes.  I am sure my lifetime exposure to radiation is way high and should have thought twice about the nuclear stress test.  However, I am currently age 62 and (knock on wood) in relatively good health.  Most of my illnesses are in my head.

I don't envy your position of having to decide on the nuclear stress test or not.  I can tell you that a clear test result will give you peace of mind for a short time, but was the exposure to radiation worth that short-term relief?  At age 35 I guarantee you that additional x-ray testing will be necessary in your lifetime.  I just needed an abdominal/pelvis CT scan which found a 1 inch kidney stone, so there was more radiation exposure, but it was necessary.  Personally, I would suggest you limit your radiation exposure at age 35 unless it is absolutely necessary.  Then, again, by the time you are 60, I am sure they will have invented a way to conduct tests using much less radiation than today. 

I would recommend against the nuclear stress test if all your other heart test results were okay.  Of course the cardiologist will recommend the test.  They also always say the radiation exposure is minimal, but it is your body and not theirs being exposed. 
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Offline spaceplus

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Re: Nuclear Stress Test
« Reply #5 on: May 05, 2014, 06:53:57 PM »
Thanks everyone for your kind and helpful responses.

Walnut, thanks for the link. I read it with great interest.
Brick, thanks for weighing in.
Patmob, the Nuke Stress Test exposes you to an amount of radiation roughly equivalent to 500 Chest X-Rays.  It's quite a bit. On a population level, it is enough to account for 1 in 1000 people developing cancer who otherwise would not have developed cancer.
AOKAY, thanks for your post. I pretty much completely agree with your take. As it stands now, I don't think an NST is prudent, for exactly the reasons you stated.

As it turns out, I feel like a complete idiot for having started this thread, because, in fact, I was scheduled for a NON-NUCLEAR Stress Test today. For some reason, the regular Treadmill Stress Tests are performed in the Nuclear lab, so my paperwork had the word "Nuclear" emblazoned all over it  in several places, in bold letters.  This is a new cardiologist I only met last week, and so far, he is not scoring points with me for his clear communication.  He never mentioned any form of stress test when I spoke with him in the hospital. The paperwork I was handed at discharge with the words "Stress Test in Nuclear lab" was the first I had heard of it.

Anyway. I am still mulling over which further cardiac tests (if any) I will agitate for in the future.  So the replies in this thread were still very helpful and informative in this regard.

Thank you, friends.
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