Why and how often should someone get a nuclear stress test after a stent?

February 25, 2010

A nuclear stress test is used to measure the blood flow to the heart muscle when both at rest and during stress on the heart. It's done similar to the routine exercise stress test, but also gives images that can help show the areas of low blood flow that go through the heart and other areas of the damaged heart muscle. Noninvasive stress testing is a vital tool when evaluating and assessing patients before coronary revascularization. In addition to this, stress testing is also useful in identifying those patients who suffer from recurrent ischemia that occurs after revascularization. This is with either percutaneous coronary intervention that is with or without any stenting or with coronary artery bypass graft surgery or CABG.

In medical terms, a stent can be defined as a man-made tube that is inserted into the natural passage or the conduit of the person’s body to either prevent, or to counteract, a disease-induced flow constriction. The term can also be used in reference to the tube that is used to hold on a temporary basis these natural conduits open allowing access for surgery. Before the stenting procedure is done, a stress test can be done to find out if a partial blockage in the coronary artery is at all capable of producing ischemia. Thus, a stress-perfusion study should be done to assess the actual functional significance of a partial blockage and to check if it is capable of really obstructing the blood flow.

However, cardiologists today are in the habit of throwing a stent at all coronary artery lesions if it is even remotely significant. The reasons cited are normally that drug coated stents can be really effective and since the patient is present in the lab it would be easier to just schedule a stress test. In most of the circumstances, a stress-perfusion testing should be done before the cath procedure since, if the test turns out to be negative, then the cath will probably not be necessary.

It is preferable that if a person is scheduled for the cath procedure and maybe a stent, then it would make sense to discuss the same with their own cardiologist. This would help the person to know what the right plan of attack would be if any kind of intermediate blockage was found. Thus this would help to get the idea from the doctor on what the underlying rationale is for and the approach that is being followed. If the solution is not an acceptable one then the patient can always get some other opinions. Acute Stent Thrombosis can occur if exercise testing is done shortly post the stent implantation. A nuclear stress test should not be done as a matter of routine.

Submitted by M T on February 25, 2010 at 02:07

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