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Can You Please Tell Me Why This ECO Test Is Still Necessary?
Question: My age is 35, from last three years I am diabetic, my diabetes is under control(hba1c 6%). Now from last 10 days I am feeling chest pain, I was feeling like acidity and my stomach was little bit disturb also. I have upper chest and back pain also. And i was feeling throat tightness.I visit the doctor and after check up she give me Acidity medicine.
After 3 days in the morning time I was sitting in lounge and suddenly I observed my heartbeat is going too fast and it was shocking for me and i was feeling lightheaded. This continued for near about 1 minute and after 10 minutes i was normal but this happened three times.
That time I don't have significant chest pain or may be no pain.
After one hour I went to hospital emergency. They have done blood pressure heart rate monitor and ECG. As per doctor all of these were normal but they told me if you have family history of heart disease then you have to go for cardiologist. My father was a heart patient and discovered in his late 40s. After visiting cardiologist at night doctor recommend me some blood test. which are CKMB and troponin . and my results were
CK-MB 0.58 ng/mL
troponin 0.012 ng/mL
Results were normal as per doctor, but due to my family history and my diabetes (i think)he gave me more test of Eco and treadmill test. which i have to do after 3 days. My question is can you please tell me why this eco Test is still necessary? Or how many chances that i still have heart issue even after blood pressure ecg and blood test all were normal?
After 3 days in the morning time I was sitting in lounge and suddenly I observed my heartbeat is going too fast and it was shocking for me and i was feeling lightheaded. This continued for near about 1 minute and after 10 minutes i was normal but this happened three times.
That time I don't have significant chest pain or may be no pain.
After one hour I went to hospital emergency. They have done blood pressure heart rate monitor and ECG. As per doctor all of these were normal but they told me if you have family history of heart disease then you have to go for cardiologist. My father was a heart patient and discovered in his late 40s. After visiting cardiologist at night doctor recommend me some blood test. which are CKMB and troponin . and my results were
CK-MB 0.58 ng/mL
troponin 0.012 ng/mL
Results were normal as per doctor, but due to my family history and my diabetes (i think)he gave me more test of Eco and treadmill test. which i have to do after 3 days. My question is can you please tell me why this eco Test is still necessary? Or how many chances that i still have heart issue even after blood pressure ecg and blood test all were normal?
Brief Answer:
I would recommend as follows:
Detailed Answer:
Hello,
I passed carefully through your medical history and I understand your concern. Let me explain that in our daily clinical practice we commonly find patients with clear evidence of cardiac ischemia ( such as typical chest pain, pathological ECG findings with elevated cardiac enzymes or abnormal cardiac ultrasounds) ; or with alternative clinical symptomatology that has nothing to do with cardiac issues.
But there are also patients like your case with suspicious clinical symptomatology and clear evidence of cardiovascular risk factors (such as diabetes, heredity for CAD). In this clinical scenario there is intermediate pretest probability of finding coronary artery issues and the best way to do this is by means of applying provocative cardiac testing such as Treadmill ECG test, stress echo or more specific and sensitive like cardiac stress MRI.
In such way the doctor can detect even a small amount of cardiac ischemia or silent ischemia without clear chest pain. That's why your doctor has decided in the right way to recommend you the above mentioned tests.
Hope to have been helpful and have clarified your issues of concern!
Let me know in case of further questions!
Kind regards,
Dr. Ilir Sharka, Cardiologist
I would recommend as follows:
Detailed Answer:
Hello,
I passed carefully through your medical history and I understand your concern. Let me explain that in our daily clinical practice we commonly find patients with clear evidence of cardiac ischemia ( such as typical chest pain, pathological ECG findings with elevated cardiac enzymes or abnormal cardiac ultrasounds) ; or with alternative clinical symptomatology that has nothing to do with cardiac issues.
But there are also patients like your case with suspicious clinical symptomatology and clear evidence of cardiovascular risk factors (such as diabetes, heredity for CAD). In this clinical scenario there is intermediate pretest probability of finding coronary artery issues and the best way to do this is by means of applying provocative cardiac testing such as Treadmill ECG test, stress echo or more specific and sensitive like cardiac stress MRI.
In such way the doctor can detect even a small amount of cardiac ischemia or silent ischemia without clear chest pain. That's why your doctor has decided in the right way to recommend you the above mentioned tests.
Hope to have been helpful and have clarified your issues of concern!
Let me know in case of further questions!
Kind regards,
Dr. Ilir Sharka, Cardiologist
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks for detailed reply...
I have mentioned my blood test reports. What is your opinion on these results. And how much possibly to still have serious cardic problem? That can come in eco test. As you can imagine i am in little stress thats why my question might be repeated for you.
I have mentioned my blood test reports. What is your opinion on these results. And how much possibly to still have serious cardic problem? That can come in eco test. As you can imagine i am in little stress thats why my question might be repeated for you.
Brief Answer:
My opinion as follows:
Detailed Answer:
Hello again!
Your cardiac enzyme levels are within normal ranges.
Regarding your concern, I would explain that the chances that you have a cardiac problem are low.
Nevertheless, I would recommend performing the above recommended tests in order to be completely sure that nothing serious is going on!
Hope you will find this information helpful!
If you have any other questions please let me know about everything!
Wishing all the best,
Dr. Iliri
My opinion as follows:
Detailed Answer:
Hello again!
Your cardiac enzyme levels are within normal ranges.
Regarding your concern, I would explain that the chances that you have a cardiac problem are low.
Nevertheless, I would recommend performing the above recommended tests in order to be completely sure that nothing serious is going on!
Hope you will find this information helpful!
If you have any other questions please let me know about everything!
Wishing all the best,
Dr. Iliri
Note: For further follow up on related General & Family Physician Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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