The thallium scan is a nuclear medicine scan, it’s not used to determine Stenosis.
Hello,
I looked at the doctor notes and he didn’t say that I have 65-70% possibilities of having myocardial ischemia but of coronary artery disease. As for the myocardial ischemia, he wrote it along with “developed at 4th and 5th stage” (of the treadmill test). He added that the accuracy of this is 90%.
Interestingly enough at the bottom of the official “cardiac sonography report” it’s suggested a “Thallium scan for further evaluation of ischemic cardiomyopathy”.
Reports and notes by the doc:
What I could find about blood pressure drops during a stress test:
A fall in blood pressure during the test indicates coronary artery disease or cardiomyopathy. The blood pressure may drop gradually as the workload is increased, or it may drop after an initial (normal) increase in blood pressure. Both scenarios are pathological. The test should be terminated if blood pressure drops 10 mmHg or more and there are other signs of ischemia. Termination of the test should always be considered when blood pressure drops 10 mmHg or more.
https://ecgwaves.com/topic/exercise-stress-test-ecg-symptoms-blood-pressure-heart-rate-performance
Now I don’t know how to read the ST changes part…
The 3D ct is to determine if you have coronary artery disease and to what extent etc.
The thallium scan will determine how much it has / is affecting your heart muscle.
Your initial post didn’t say what the doctor wrote. So he wants the 3D scan to see the situation with your coronary arteries.
Would you recommend doing both? a nurse friend seemed to be much more inclined towards the catheter way.
Honestly I would just get the CT scan done. The doctor wants to know what the cause is and suspects coronary artery disease. He’s looking at that with the scan. He’s going with the most accurate method of looking at it. Trust him and follow his advice or get another doctor, but I’d imagine the advice will be the same.
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Maybe. My friend and her colleague seem to think catheterization is the best way, but honestly that scares me. They also said thallium could be helpful.
Would thallium be better than the 3d ct in any way? Just to know.
All of this is affecting me, giving me a bit of anxiety which doesn’t help at all.
Anyway, thanks everyone for the insights
3D CT is the gold standard for what he is looking for. Not catheterisation. It’s fast and non invasive.
The Thallium scan isn’t looking at the same things. So yes it will provide different information. But it won’t give the answer to the question your doctor is looking at. The thallium scan will show the blood uptake of your heart and show any areas that have less blood than others. It won’t show where the blockage or narrowing is that caused it.
Whatever scan you have I’m sure it won’t be the end of the examinations. They will look more closely once they have the results of the 3D scan. It’s not a one day visit where you get all your answers it’s the first step. The 3D scan makes perfect sense to me, based on what he is looking for.
Your choice isn’t what scan do you need based on my advice or your friends advice. Your choice is to trust your doctor or find one you do.
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After many disappointments I don’t trust doctors. One of these situations will be object of a separate post, and it’s related to this case, but it happened 2 years ago.
Again, thanks for all.
I know, but your choice is ultimately which doctor do I trust, or which one do I distrust the least. You can’t trust me more I haven’t seen your medical history, and I’m not a cardiologist. Neither is your friend. A bad experience doesn’t mean all future experiences will be bad. I can say what he is requesting makes sense for what he is looking for. It’s stressful for you, get the scan done, the only thing you have to lose is the 20,000nt which in the grand scheme of things is irrelevant. And then maybe you get a definite answer. Or maybe another question. But you will be moving forward and that alone should make you feel somewhat better
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Yeah, I decided to do the 3D CT scan and I’ll ask him to do the thallium scan too. Doing both will be better for getting more information, and I’ve been told that the 3D CT scan can throw false positives if there’s calcification in the arteries. Also the thallium test was suggested in the stress report test as can be seen in the picture posted before (I don’t know why he didn’t mention it).
So this Christmas I will get a 3D representation of my heart. How lucky.
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The 3D scan is to detect if there is calcification in the arteries , that would be the cause, it shows structure. The thallium scan shows the physiological impact. You will feel better once you know what is happening.
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Hey. I am knowledgeable in this area, and @riggers is giving top quality advice. You should listen to him/her.
Agree you should get the scan done, for all the reasons riggers said. From the results it does look like you have coronary disease and likely ischemia, but the 3D scan can confirm it.
Second opinion is fine of course, but the treadmill test is fairly conclusive to my eyes (though I am not your doctor, have not assessed you personally etc etc).
NHI covers the basic tests you need. That would mean CT angiogram. But it’s more invasive, has some risk (contrast agent, risk of triggering a clot etc). The 3D image is better, but more costly. Honestly, 20,000NT is still a bargain.
Best of luck and please keep us updated
Maybe I’m wrong but my understanding is that it will show stenosis, which can be caused by a number of reasons including cholesterol and or white cells and other waste accumulation. This isn’t called calcification, isn’t it?
Does anyone remember a user here who said he was a doctor and we could ask him/consult him?
Wasn’t he a Chinese medicine quackery “doctor”? Joey something or the other.
I was referring to your comment about it throwing false positives if there was calcification. It won’t , it makes a 3D reconstruction of what is physically there. The radiologist will be able to take measurements to determine exactly how long any narrowing is etc.
I saw that CT scan exposes you to radiation and I already had another scan done within this year… and several x-rays these past years. Is it still a good idea to do this or perhaps too risky?