What's a nuclear stress test like? Is it safe?
I had an EKG and my doctor dictated that it showed the following: Sinus Rhythm 79 PVC Inferior Lateral ST Depression. My doctor has ordered a nuclear medicine stress test because I have some back problems and I was concerned about doing the treadmill stress test. I guess I have two questions/concerns and wondered if anyone might shed some light on either of them. First, what does this dictation that my doctor put in my record mean about my EKG? I have had a benign PVC all of my life but don't know if this is the same thing. I had been feeling like my chest was heavy and very tired, a little breathless sometimes which is why I went in to the cardiologist. Second, has anyone had a nuclear medicine stress test? I am concerned about the side effects and not being able to control them. I read about some of them and saw that the FDA had issued a warning about risks with nuclear medicine stress tests. Then I saw on the Mayo Clinic site that the nuclear medicine test may be more accurate and if the regular treadmill one isn't conclusive, I might end up having to do the nuclear one anyway. It was an ECO stress test I had many years ago when the benign PVCs were discovered. I am really afraid of doing the nuclear test. Please guide me if you can.
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I have sinus nose.now worried.
Hi again! After reading the information from the Lexiscan site (5.2 and 5.3) and doing a little more research into your situation, I can see your hesitancy in regards to having this test done with your current symptoms. I misunderstood before. I thought it was regarding the test itself.
You’ve already been diagnosed with Afib and arterial fluttering after wearing the monitor and have tachycardia/bradycardia symptoms, both of which can be complications of sinus mode dysfunction. And that is definitely on the contraindication list of this test, unless those conditions are being corrected with a pacemaker.
If this were me, I’d certainly want reassurance too before going ahead with this.
Digging a little further on various sites, sinus mode dysfunction or, it’s also called sick sinus syndrome is determined with an ECG, an event monitor-ECG which you wear for a few days, a Holter monitor, or an implantable loop recorder that records your heart over a longer period of time if you have irregular episodes of symptoms.
Here’s some information from the Mayo Clinic site on Sick sinus syndrom.
In my unprofessional but concerned opinion, it’s in your best interest to get further information from your cardiologists office. I know you’re not very comforted by the fact that they seem overworked. But that should have no bearing on how you should be treated, if nothing else it is all the more reason for you to ask for clarification. Is there a patient portal where you can contact the doctor or a member of his team, Nurse practitioner, to address your concerns?
Hello again, Lori! I am so glad you understand my concern about having the stress test done BEFORE sick sinus syndrome has been ruled out. I will reach out to the cardiologist's office again for more info, as you suggested. Though I filled out a form two weeks ago asking to register for the patient portal, I have yet to receive the e-mail invitation from the office to initiate the registration. (Big sigh.) So to voice mail I will go.
I have this anxious fear of being seen as a "pest," so your encouragement and concern are more comforting to me than you can know! Thank you again!
I think the fear of being a pest is understandable but imagine if the patient in question were your child, you'd 'pester' any doctor for any reason in the interests of getting the best care. Most doctors welcome a patient who is fully proactive in his or her own care. Those are the patients likely to actually participate in protocols that advance their health, making it rewarding for doctors to see the results of their education and training and experience.
I had a nuclear stress test in 2018 after having "failed" a conventional one (the attending dr. stopped it because he thought he saw my HR begin to descend after reaching 112 bpm; I did not notice this). They were testing my asymptomatic bradycardia (my HR had gone as low as 21 bpm on holter while in sleep). I was so conflicted and terrified to do the nuclear test that I didn't sleep the night before, but the experience itself was not bad and in some ways revelatory. The attending doctor (same person as before) warned me that they may need to give me drugs to make my heart pump fast enough, but on this occasion a nurse was present by the heart monitor who spoke reassuringly as I got on the machine. I was almost in tears as I walked, but she kept reassuring me and my HR reached 140 without drugs. Maybe it would have anyway, but I felt incredibly lucky to have had her by my side.
Advocating for your health is in no way being a pest. I second what @callalloo mentioned about, if this were for your child you wouldn’t hesitate to pester a doctor to get the best care. Well, your health is equally important.
So approach this in the perspective that the doctor works for you and is in a partnership with you to keep you healthy. Don’t apologize for asking questions. Knowledge is power. As a patient it’s natural to have questions about your health and the tests being given. In the case of this particular stress test, you see a cautionary red flag considering your symptoms. So be pleasant but remain firm in your resolve to get an answer. Have notes of what you want to say and why you have the concerns.
From experience, a reply for an email invitation to a patient portal is usually pretty quick. So you might want to check into that again as well. But definitely call. Do you ever get to speak with a receptionist or is it always voice mail?
It's uncommon to have anyone answer the phone. To schedule or change an appointment, one generally gets voice mail and receives a call-back within 24 hours. I do have a specific extension number for the doctor's team, though, and will use that. I will let you know what happens — thanks.
Good morning, @bettysamny
I just saw this reply and understand it to mean you have sinus node dysfunction? When you go today, make sure you speak with the technician. As I told @bay20740, I am not a medical professional but I spent time researching this information yesterday in regards to their concerns about this particular stress test. The Lexiscan website says it’s contraindicated when you have these symptoms.
However, since both of you have similar conditions and both of your cardiologists have ordered this test, it may be that the warning is one of a broad range and is more a cautionary notice than a serious complication. Similar to a medication when there is a declaration on the box of all possible side effects when it is a very small number of people who react.
I’ve had this scan and it gives a lot of vital information so it may work in conjunction with the other tests you’ve had. Speak with the technician before your procedure. This may be pretty common and nothing to worry about. But you don’t have the luxury of time today to call ahead and ask questions from your doctor. That doesn’t stop you from asking the technician if this is a routine test for someone with Sinus node dysfunction.
I do want to wish you good results today. ☺️ Did you feel a little more comfortable after I explained how the test works?
Thanks . I had a great technician.He told me only one incident in which a person's bp rose and later redid test well.Said never another incident in ten years and dr.said same.Dr said don't listen to those not in the medical field..I was totally ok..Normal findings.
I just had one.Measures blood flow in arteries..finds plaque..sees damaged partsmm
To see if any of that causing AFib.not in my case.