Nuclear Pharmacologic Stress Test

[icthus]

At my appointment with the neuro yesterday, I told him that the EP thinks I might have variant angina (Prinzmetal) and that I'm now almost 24-7 housebound due to dysautonomic issues. He was insistent that I have a nuclear pharmacologic stress test to rule out CAD because women tend to be underdiagnosed for CAD.

After some internet research, I couldn't find any info that said this test rules out CAD, and in fact, that it does not predict future heart attacks. It is only able to differentiate the difference of blood flow in the heart chambers but not the amount of blood flow in the heart chambers.

QUESTION: What is/are the best test/s to evaluate CAD status in a patient? Is this a reasonable test?

Any thoughts - I'm scheduled for the test tomorrow but I'm leaning toward rescheduling.

[Guest tearose]

I too was told I probably have Prinzmetal!!!

I don't know what to suggest about the test. I have only had regular stress tests.

The pain from my variant angina comes in the colder weather, in the early morning usually after having really over done activity the previous day. It was so frightening, the first time I was standing and it brought to my knees! I called out "God, please don't take me yet!". I really thought I was going to die. The intense pain passed as quickly as it came on. I did feel wiped out for the rest of the day.

I have had two major episodes and two minor. I have been much much more selective with how I push myself now and have not had any recurrence since last fall.

I hope someone can share their experience with the nuclear stress test with you.

best regards,

tearose

[mkoven]

I also have probably variant angina and now take a low dose of norvasc once a day. the doc thinks my autonomic fluctuations trigger it. Apparently the test for this is to administer ergovonine (sp?) during an catheterization to try to provoke a spasm. I didn't do this, as it's a somewhat dangerous test, and my local doc thought we could see if the meds helped.

I had a full cardiac workup this summer, because I was having a lot of chest pain. One of the tests was an adenosine thallium stress test. I think it's considered a good test to see that your heart is getting a good blood supply--USUALLY. I had a false positive though, probably because breast tissue got in the way and made it look like my heart wasn't getting enough blood. So there are false positives and false negatives. I ended up having an catheterization, which is considered the "gold standard" for diagnosing cad-- but it's quite invasive. My arteries were clean. (Apparently they now say that women can have blockages in the small vessels that one can't see on a cath, and it's a gated mri that looks for small vessel disease.) I think CAT scans can also be done instead of catheterization, but that is also controversial and a lot of radiation. A nuclear stress test is probably reasonable, but no test is perfect. Mine unleashed a series of other tests...