Nuclear Stress Test After Echo ...

[Jkm7]

I hope you can help me understand this.

I recently had another echo which showed my mitral valve with more regurg than the echo I had about 9 months ago. It also showed a lower pump function and more heart enlargement.

My Cardio has scheduled for me to have a Nuclear Stress. I had one about two and a half years ago but not since.

What sorts of things would he be looking for?

I had heart attack and double bypass 2 1/2 years ago. Would the nuclear stress show if the bypasses were clogging? Would it show blockages in other arteries formerly thought to be clear?

Doesn't an echo show more about valve leaking than a nuclear stress?

Of course, I am concerned and while my cardio is great about answering my questions, unfortunately, I didn't ask these questions.

Thank you if you can help.

 

[BillCobit]

I hope you can help me understand this.

Would it show blockages in other arteries formerly thought to be clear?

Doesn't an echo show more about valve leaking than a nuclear stress?

Nuclear stress test shows how well your heart muscle is supplied with blood. Poor perfusion is typically indicative of restricted flow through arteries - but it doesn't show which arteries - it's much less specific than an angiogram (safer & non-invasive though). If perfusion of the heart muscle appears inadequate with a stress test, your doc may follow up with an angiogram.

You are correct, echo is the standard for assessing valve function. Nuclear stress tests aren't used for assessing valve function.

 

[Jkm7]

Thank you, Bill.

So, if I understand, the echo indicated there may be a blood flow problem, perhaps some blockages. So, he's doing a 2 day nuclear stress to see if that is the case. If they find there is a lower than normal blood supply going to my heart, he won't know if it is the previously bypassed arteries that are blocked or if it is other ones.

So....they really get very little information from this two day test. Only enough information to decide whether or not to do more tests? An angiogram?

 

[BillCobit]

Echo gives an indication of the mechanics of a pump (your heart) - the heart motion and valve function visualised on an echo help assess the functional pumping capability.

Nuclear stress test provides an indication of how well blood is being delivered to heart tissue. Radio dye is pumped throughout your body - the distribution of the dye within your heart shows how well the heart muscle is being supplied with blood. If radio dye distribution is non-uniform or less-than-expected within the heart, then there is suspicion of either prior heart muscle damage, or reduced flow to the heart through the blood vessels supplying it.

An EKG rhythm disturbance frequently indicates heart muscle damage, so if the EKG is clean, but the distribution of radio dye is abnormal, then it's a good hunch that there's physical blockage or constriction of coronary arteries.

A valve problem doesn't typically suggest the need for a nuclear stress test. However, abnormal heart motion that is visible on an echo may suggest prior heart muscle damage (eg heart attack), which would be an indication for a nuclear stress test.

heartcenteronline.com has some very good articles and interactive lessons on these diagnostic tests and the heart conditions they're used to diagnose. You may want to check these out.

 

[Jkm7]

Thank you for your very helpful information, Bill.