re my original question

[jimbo1234]

So guys what i'm basically asking if you could only have one heart test what would it be?

im on a budget dont fancy paying £1000 for the full monty of tests I realise people on here are not experts. but id like to know your thoughts

[IChoose]

1) Doctor takes your blood pressure and listens to your heart ... Any questions then 2) Doctor does EKG (those 2 should be part of your annual physical). Any questions after 1) and 2), you see cardiologist.

Cardiologist repeats 1) and 2). Then, cardiologist decides what's next.

When I got referred it was due to abnormal EKG. Cardiologist found abnormal EKG as well at rest and on cardiac stress test. During the test he said my BP went fast to 170/140? and I did get out of breath. He said my heart is getting tired. This was at age 53.

An ECG ultrasound of my heart showed hypertrophy of heart muscle. I was told later there were indications of possible infarction as well as congenital issues. Some folks on one side of the family die young from heart trouble.

The cardiologist issued a letter for my job that I was not to lift, push, pull or carry anything over 20 pounds.

Soooo ... Long answer, I learned a lot from the tests that could save my life one day.

I recommend you listen to your cardiologist.

[MichaelJH Heart Star]

Hello... With the initial consultation (you cannot just roll up) the three tests you suggest would probably cost in excess of £2000. So what tests to have? Mine, and a friend's, resting ECGs were perfectly normal (or in cardiology terms unremarkable). His exercise ECG was halted in a few minutes, he was admitted on the spot and had a triple bypass five days later. So I agree with Hidden that this is the most important test. However, with your history I would also recommend an echocardiogram to check on your heart's structure. @

[Milkfairy Heart Star]

Just a thought,

My brother in law having private health insurance through work, reguarily saw a very eminent Cardiology Prof for years. He had a stress test.

Passed with flying colours.

A few weeks later he had a heart attack and out of hospital Cardiac arrest.

He was 46 at the time. His life was saved by the NHS.

My husband also had a private stress test through work which missed his nearly completely blocked main coronary artery.

He developed angina the day after the test. Stent inserted by the NHS when he was 47.

Again through work health insurance my husband recently had a stress echo....it cost £1,800.

[Alf01]

I would say a stress MRI with contrast dye.

[Chappychap]

Hello James, unfortunately there is no test that definitively details our individual risk of a heart attack.

The problem is this. A test such as a CT Heart Scan (which will cost you about £600) is non invasive but by measuring the calcium build up in your heart will give you some information on the degree of plaque in your heart arteries. This information can in turn be used to predict your mortality risk. But let's pause for a moment and look at the limitations of this procedure,

1. The prediction is based on previous observations of other patients, and I guarantee that the spread of the data will be very, very wide,. So even though it's a numerical prediction, it's one with pretty low level of confidence.

2. This scan tells you little about the flow of blood through the arteries, for that you need an angiogram. But because an angiogram is invasive and carries some risk, cardiologists won't approve it without more evidence.

3. Build up of calcium isn't necessarily a bad thing, calcium indicates stable plaque. Of course we'd all prefer no plaque and therefore no calcium, but if we are going to have plaque then stable calcified plaque is the kind you actually want!

4. Remember that about half of heart attacks happen to people with less than 50% stenosis (arterial blockage by plaque), so the correlation between heart attacks and plaque build up is far from perfect.

We could go through each individual test and conduct a similarly sceptical analysis. The hard truth is that any test gives only a single piece of a complex jigsaw puzzle. They're useful as aids for an experienced cardiologist to construct a prognosis, but for the layperson they're a lot less informative.

If you have deep pockets then sure, by all means satisfy your curiosity with a battery of non-invasive tests and repeat them at regular intervals to monitor progress. It's your money so you're free to spend it any way you wish. But if money's tight I'm not sure this is best use of your cash.

Incidentally, congratulations on your weight loss and the other substantial life style improvements that you've already made. Now they really are worthwhile!

'll leave you with a conclusion from a massive study that monitored about 8,000 British patients across many years. Take two groups of fifty year old men. The first group doesn't smoke, has a healthy weight, and exercises regularly. The second group smokes, is obese, and rarely exercises. Over the next fifteen years, so up to retirement at age 65, the first group has an 89% chance of surviving without a heart attack, stroke, or being diagnosed with Type 2 Diabetes. But the second group has only a 42% chance of making it to retirement without a devastating incident. Think about that for a moment, none of us can ever get a guarantee, but life style choices is the difference between odds that range from nearly nine in ten, down to less than fifty/fifty!

What you're doing James, by embracing a new healthier life style, is absolutely the best thing. Personally I'd say to anyone, invest your money in gym membership or help in quitting smoking, or any other beneficial life style activity, rather than in tests. Because at the end of the day that's what's going to make the big difference to your future.

Good luck!

[Dovaston in reply to Chappychap]

Great response 👍

[jimbo1234 in reply to Chappychap]

Fantastic response. Question answered completely

[Chickenlou]

My fiancé had the following tests with the following results:

ECG (at gp surgery) - normal

ECG (in cardiology dept) - normal

Stress test (in cardiology) - was not preformed as cardiologist didn’t feel it would be useful (his words not mine!) As he believed the chest pain to be likely muscular as ECG ok

CT scan with contrast - several blockages/stenosis high levels of atherosclerosis in artery’s.

Angiogram - 90% + blockage of 2 places on his LAD artery and 2 more minor ones elsewhere (both over 50%) Angioplasty was attempted but placement of stents failed due to the damage in his artery’s.

He then had an urgent triple bypass.

So from his point of view the CT scan was definitely the “important one” as without it he wouldn’t have had a diagnosis....and the angiogram was also vital to really see where the problems were.

I don’t think one test can ever be relied upon 100% as if he’d just left it at the normal ECG then we possibly wouldn’t have known what was wrong until it was too late.