What does a cardiologist have to say about the belief that doctors order too many tests for heart disease?
These tests include stress tests and angiograms. There are also various blood tests related to diseases of the heart.
“Recent data has confirmed that we are over-testing our patients,” says Monica Reynolds, MD, a cardiologist with ColumbiaDoctors Medical Group in White Plains, NY.
“Regular echocardiograms and stress tests in patients with low risk profiles and atypical symptoms do NOT prolong life or improve quality of life.”
A low risk profile might be a man or woman under age 45 who does not smoke, does not have diabetes, does not have high blood pressure and is not overweight.
Another example of a low risk profile is a 55-year-old man who has always been an exercise enthusiast, has none of the problems mentioned above, is only a little overweight and has no family history of early-onset coronary artery disease.
What about stenting in patients with blocked arteries but no symptoms?
“In fact, stenting arteries that are partially blocked but have not caused symptoms does NOT prolong life or improve quality of life,” adds Dr. Reynolds.
The CT Angiogram
This non-invasive but radiation-emitting procedure involves looking at the inside of coronary arteries via the use of a contrast dye that lights up blood vessels on an imaging screen.
The CTA can view soft plaque buildup inside the arteries. Soft plaque is unstable in that a piece of it can break off and block blood flow or trigger a clotting mechanism that obstructs blood flow in the heart.
Dr. Reynolds explains, “CT angiograms looking for soft plaque is of very debatable use in a patient with a low cardiac risk profile and only atypical symptoms.
“Patients are better served by changing their diet, exercising more, and taking medications when necessary to reduce cardiac risk.”