Nuclear Stress Test - Not accurate

Posted by briarrose @briarrose, Jun 14 6:22am

I am wondering if anyone ever had a pharmacological nuclear stress testing result which were inaccurate?
This was a 3 1/2 hour test at a reputable cardiology group/medical center. It showed my husband had an area of the inferior wall of the heart consistent with a infarction (heart attack). Since he never experienced any pain my first thought was a "silent" heart attack which can and does happen. We received this news over the holiday w/e and it was upsetting. The follow up echocardiogram testing was completely normal. Our cardiologist said there was an "artifact" on the nuclear stress test and it was inaccurate. However, his report has not been changed to reflect this. Results remain as is, despite my request to reflect "accurate" results and remove this part of the result.
I have never heard of an inaccurate nuclear stress test...and I personally had many in my life. The cardiologist did not clarify "what" the artifact was. how it could happen and b/c the echo was "fine", no repeat of this test ordered. Has anyone ever experienced this in their nuclear stress testing? Perhaps it's me but I find it alarming and unacceptable. This test result is now part of his medical record and it's wrong.

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lenmayo | @lenmayo | Jun 15 10:40am

It's unethical to give tests without symptoms. It only complicates things!

briarrose | @briarrose | Jun 15 1:47pm

In reply to @lenmayo "It's unethical to give tests without symptoms. It only complicates things!" + (show)

@lenmayo If your post refers to my posts re: nuclear stress testing:
Yes, you are right.
Professional, ethical and upstanding physicians do not order any unnecessary medical tests when a patient is asymptomatic. Ever.
However, my husband was experiencing upper chest pains and has an aortic aneurysm.
He was long over due for cardiac testing and was symptomatic.
It was not his or my decision for him to have a cardiac workup - although I certainly thought it was called for and medically necessary, as he did also, to rule out any cardiac abnormalities and evaluate if his aneurysm was enlarging to a dangerous and possibly fatal size.
Our cardiologist is highly rated, at a highly rated cardiovascular center.
It was entirely his call to order such testing.
In his medical opinion, he felt it was necessary - it was not an unethical call in anyway, shape or form.
Not sure if you are referring to my previous postings or you simply wish to post an obvious statement. If the former, I hope I cleared this up for you.

jenatsky | @jenatsky | 4 days ago

Medical tests are read by human beings. We are all capable of making mistakes. Just because they have an MD, DO, NP, etc. after their name doesn’t change the fact that they are human too. AI has been a big help in reading many test results but AI may have not been incorporated into Nuclear Stress Testing as yet.

briarrose | @briarrose | 3 days ago

Yes, of course, you are right.
However, I and my husband were informed by our cardiologist and nurse several times that it was an "artifact" that caused the "error" - it was not human error.
The nuclear stress testing "machine" caused the error, the "artifact". The cardiologist stressed this to us.
It is a false feature or distortion on a result or image that is not present in the patient.
Often caused by: Equipment or patient movement (found often in EKG's...that's why the technician will say "hold still" while an EKG is being done).
It was such a big disappointment that this highly regarded cardiac test - which cardiologist's depend on so much to help diagnosis heart disease in their patients - was "off".
3 1/2 hours "off" - waste of time for everyone involved. I'll post the billing charges when I get them.

tabicat03 | @tabicat03 | 3 days ago

In reply to @briarrose "@tabicat03 Yes, it seems you are between a rock and a hard place. Your test results..." + (show)

@briarrose

@tabicat03 Yes, it seems you are between a rock and a hard place. Your test results are certainly not clear...what you wrote sounds like only a cardiologist can interpret.
"Chest wall attenuation" can mean lots of things (yes, I googled it too, including "artifact") so not sure exactly how this applies to your cardiac health issues.
The good news is no infarction or ischemia. And your ST wave (EKG) did not show an "elevation" during your stress test exertion which is clearly an indication of ischemia/block coronary arteries requiring a coronary catheterization for further evaluation, possible stent placement or even possible by-pass surgery depending on your particular heart picture.
Waiting until December to discuss your test results in person is awful! But certainly not uncommon these days. A couple of thoughts: You can speak to the cardiac nurses working with your cardiologist, express your concerns and fears. They will take all your issues and "should" present it to your cardiologist and it would be the RNs who get back to you in addressing your immediate concerns.
Or - what about a telemedicine visit? I have found booking in person is often a far out appointment but telemedicine is usually within a more reasonable wait time.
And if your cardiologist "team" has a couple of disciplines working in the office - a Physician Assistant (PA, hopefully certified) or even a Nurse Practitioner (NP, again, hopefully certified) such staff might be the folks who do the telemedicine with you...which would be fine as you wait for your December appointment with the big guy. Such staff in your cardiologist's office would report back to him/her and all work together as a team (at least, they should be).
And another final thought: I more than hope you are working with a cardiologist who is "in tune" to heart disease in women and in "young" women like yourself. Just about every study done in heart disease was done on "men"...heart disease in women presents an entirely different picture than men. Big Time. I don't mean to scar you - but it is a fact. Heart disease is the # 1 killer of women in the US. More than all the cancers combined. And heart disease can and often shows up in women in your age bracket. Mine did...in my late 40s. I am now 71.
So, if you have a cardiologist (old school) who simply dismisses your concerns and your symptoms - think twice about staying with him. You want a cutting-edge physician who is skilled, understands and is top notch competent about women and heart disease.
However, your cardiac picture remains unclear at this point.
Hopefully you will get it all settled appropriately. I think you will!
All the best to you.

Jump to this post

@briarrose Thankyou for that response 🙂 My goal like everyone else is to be here for a long time!! I did actually speak to my cardiologist last week- I bothered him until He said come into the office and let's discuss!! He said like you said no infarction or ischemia. My Mets were 11.2- and that the fixed perfusion based off imaging was an artifact...even though in my brain it can go either way. "GOOGLE" can sometimes be our friend but can also scare the heck out of us. He did make me feel better as I had a whole list of questions for him!!! He told me he did not feel justified with a Cath at this time because my Mets of 11.2 were so good. (Treadmill) however, I have read top athletes can get an amazing test result and still have blockages. I did not have any chest tightness or feeling out of the norm while testing so I guess that is a good thing?!! So, if there is any type of blockage I guess we are at the beginning of a long journey!! He wants to put me on Rosuvastatin and a daily aspirin... (CAC score of 21.1) I just don't know what to do. Thank you again for your response!! Here is to long Gevity and trying to make it to 70!! I pray the good lord gives me many many more good years!!

lenmayo | @lenmayo | 3 days ago

In reply to @tabicat03 "@briarrose Thankyou for that response :-) My goal like everyone else is to be here for..." + (show)

@tabicat03 Have you had a Calcium Scoring test?

tabicat03 | @tabicat03 | 3 days ago

In reply to @lenmayo "@tabicat03 Have you had a Calcium Scoring test?" + (show)

@lenmayo I did have a CAC score of 21.1. I have lived with it for 3 years now- If I was to bet I am sure that score would be higher now considering it's been almost 4 years. It's almost like I am just waiting for something to happen- My Doc said he don't feel justified in sending me to the cath lab- I hope he's right...it's my life that's being gambled with not his...I will say this- he is only 5 years older than I am and he too has a CAC way higher than mine- so I do trust his judgement- but can't explain away my symptoms...Its frustrating.

njx58 | @njx58 | 3 days ago

In reply to @tabicat03 "@briarrose Thankyou for that response :-) My goal like everyone else is to be here for..." + (show)

@tabicat03 If your CAC is over zero, then standard procedure is to take statins, which will prevent further accumulation by lowering your LDL as well as calcify any "dangerous" soft plaque you may have. So, yes, you should be taking it even though you have no symptoms. I have a CAC score higher than yours, and I am a runner and have no symptoms - but I still take a statin.

Do you have an LDL test result?

tabicat03 | @tabicat03 | 3 days ago

In reply to @njx58 "@tabicat03 If your CAC is over zero, then standard procedure is to take statins, which will..." + (show)

@njx58 I am having my 5mg rosuvastatin filled today. My cholesterol levels have always been normal- 178.
LDL was a little high this past time at 103
HDL was 65
Triglycerides 51

Cardiologist wants my LDL below 70. So, I will take the Statin/Aspirin.
I just hate the thought of the statin raising my CAC score 🙁

njx58 | @njx58 | 3 days ago

You WANT the statin to raise your CAC score. That's a good thing, not a bad thing.

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