The angiogram and cardiac catheterization are the most definitive tests, better than a nuclear stress test, but both use significant radiation, and the cardiac catheterization uses a large catheter in the artery, which can cause complications.
Even more options than these are available at major centers, including CT angiography, coronary MRI angiography, single-photon emission computed tomography (SPECT) myocardial perfusion imaging, and cardiac positron emission tomography (PET). Some of these deliver radiation; some don't.
A coronary angiogram is a type of X-ray used to examine the coronary arteries supplying blood to your heart muscle. It's considered to be the best method of diagnosing coronary artery disease - conditions that affect the arteries surrounding the heart.
CT angiography offers much more rapid results than nuclear testing, which takes several hours.
Advantages of Nuclear Stress Testing
is the most accurate test available for diagnosing coronary artery disease (CAD) early in patients who may be at risk for a heart attack.
The HeartFlow Difference
The HeartFlow Analysis is the first and only non-invasive test which enables your physician to understand the impact that narrowings and blockages have on blood flow to your heart – information that otherwise would only be available with a riskier, invasive procedure.
MRI is much more accurate than both nuclear and echo stress, and a cardiac stress MRI provides more information than perfusion, including viability, function and morphology, at a much higher resolution than either nuclear or echo,” he says. Cardiac MRI is a well-validated tool.
“Most people think a stress test identifies blockages to the heart, but it does not,” explains Aristotelis Vlahos, M.D., director of the Cardiac Catheterization Lab at Riverview Medical Center. “It looks at blood flow to the heart muscle and determines if blood flow is adequate or not.
The test can show the size of the heart's chambers, how well the heart is pumping blood, and whether the heart has any damaged or dead muscle. Nuclear stress tests can also give doctors information about your arteries and whether they might be narrowed or blocked because of coronary artery disease.
If a coronary artery becomes completely blocked, the blockage can cause a heart attack. The lipoprotein test is a blood test for coronary artery disease that estimates levels of LDL cholesterols that may have attached to a coronary artery - by simply assessing the level of lipoprotein (a) in the blood.
You should not have a nuclear stress test if you have certain conditions that are severe or not controlled, such as: Angina. Aortic dissection. Aortic stenosis (narrowed aorta).
The nuclear stress test is generally considered to be the most accurate type of stress test. It has a sensitivity of about 81%, meaning that it will miss about 19% of high-grade blockages.
A nuclear stress test is generally safe. Complications are rare, but there is some risk. Complications might include: Irregular heartbeats, also called arrhythmias.
Even so, the doctor might still want to do more tests. But it's important to understand that a "normal" stress test can't rule out the chance that a plaque will later rupture and block an artery—the proverbial tale of the man who passes a stress test with flying colors and then has a heart attack a week later.
The test is done to see if your heart muscle is getting enough blood flow and oxygen when it is working hard (under stress). Your provider may order this test to find out: How well a treatment (medicines, angioplasty, or heart surgery) is working. If you are at high risk for heart disease or complications.
Through angioplasty, our cardiologists are able to treat patients with blocked or clogged coronary arteries quickly without surgery. During the procedure, a cardiologist threads a balloon-tipped catheter to the site of the narrowed or blocked artery and then inflates the balloon to open the vessel.
The radioactive liquid leaves your body through your urine and bowel movements. Anyone who touches your urine or bowel movements should also wash his or her hands. Limit time to cuddle and hug children under 3 years old. Limit close time for up to 18 hours after your test.
Stress tests with pictures include stress echocardiograms, nuclear stress tests, and cardiac (heart) MRI stress tests.
Echocardiogram (ultrasound)
An echocardiogram is a common test. It gives a picture of your heart using ultrasound, a type of X-ray.
There are two types of nuclear stress tests, one that is used in conjunction with exercise (exercise stress test) and one that is used in conjunction with medication (pharmacologic stress test).
Calcium scans can be more effective at identifying plaque build-up than compared to a stress test in some instances. For example, if all of a person's arteries are blocked, a stress test's measurement would look the same across the board and not show a concern.
Echocardiogram. An echocardiogram (echo) is a test that uses sound waves to create a moving picture of the heart. The picture is much more detailed than a plain x-ray image. This test helps your health care provider learn more about how well your heart contracts and relaxes.