Study: too many invasive heart tests?

iVillage Member
Registered: 03-09-2001
Study: too many invasive heart tests?
8
Thu, 03-11-2010 - 10:58am
http://www.google.com/hostednews/ap/article/ALeqM5iomeS2KY0RNETPv_w9sdj79JTUPwD9EC2K3G0



"Study suggests too many invasive heart tests given

By MALCOLM RITTER (AP)



NEW YORK — A troublingly high number of U.S. patients who are given angiograms to check for heart disease turn out not to have a significant problem, according to the latest study to suggest Americans get an excess of medical tests.



The researchers said the findings suggest doctors must do better in determining which patients should be subjected to the cost and risks of an angiogram. The test carries a small but real risk — less than 1 percent — of causing a stroke or heart attack, and also entails radiation exposure.



"We can do better. There is no doubt in my mind," said Dr. Ralph Brindis of the University of California, San Francisco, one of the study's authors.



Every year in the United States, more than a million people get an angiogram, in which a thin tube is inserted in the arm or groin and threaded up to the heart to check for blocked arteries that could lead to a heart attack. Dye is injected through the tube to make blockages show up on X-rays.



Angiograms are often given to patients who might be having a heart attack or have symptoms that suggest a serious blockage. They are also sometimes done on people who may have some less clear-cut symptoms, like shortness of breath, or no symptoms but some risky traits like high cholesterol and an abnormal result on another heart test. This group accounts for about 20 to 30 percent of angiogram cases.



In the study, nearly two-thirds of the patients in this second group were found to have no serious blockages.



The researchers could not establish why so few proved to have heart disease. But Dr. Harlan Krumholz, a Yale cardiologist and health-outcomes researcher unconnected to the study, said he thinks the problem arises because doctors are afraid of missing something, and also getting sued.



"We fear doing too little," he said. "I think that we developed a culture where people feel that doing more and knowing more is always the proper course. What that does is sometimes lead us to overuse."



(Article continues....)



In my case, they should have at least done EKGs or something on a check-up basis, IMO. I had three completely blocked blood vessels in my heart *and* dead heart muscle from a heart attack I never knew I had! And the *only* reason we found out was because I had "flunked" an EKG for a minor surgery! :O Otherwise, because my blood pressure was well-regulated on Rx's, no checks would have been done. So, I think *some* tests ARE important and not a waste or over use. If I hadn't had that surgery scheduled, no EKG or anything would have been done and I could have died with a major heart attack, given what they found in the heart catheterization... So, while an invasive test might not be indicated for someone like me, who had no symptoms of any kind, *some* sort of test should be, IMO! Especially as regards women, as we often have NO warning symptoms whatsoever! I had been living on "borrowed time," and neither I nor my doctors had a clue that was the case. ://



Blessings,

Gypsy

)O(



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iVillage Member
Registered: 08-07-2007
Thu, 03-11-2010 - 2:03pm

I agree with you Gypsy, I think there maybe aren't enough tests done, despite what this study says.

Community Leader
Registered: 12-21-2001
Mon, 03-15-2010 - 6:35pm

I agree with the article that too many invasive heart tests are often

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iVillage Member
Registered: 03-11-2004
Mon, 03-15-2010 - 7:03pm
I'm w/Amy on this one. Too many women w/heart disease are being missed. My 77 yo mom was diagnosed a few months ago w/Meniere's. She was seen by her internist & two ENTs. Two weeks ago she was so weak that my dad had to dress her & was complaining of back pain & shortness of breath. She suffered a heart attack in the helicopter during transfer to a cath lab @ a medical center. She had two blockages & stents put in. She's doing ok. But... noone even did a stress test. Just agreed w/her that she was dizzy. OMG! jan

gem21uk

 

 


 



iVillage Member
Registered: 11-16-2001
Tue, 03-16-2010 - 11:56pm

Isn't the EKG part of a yearly health examination in the US?

Both my parents had heart problems, so I am due for an appointment with a cardiologist to check that everything is alright. And EKG is is part of the examination.

My father had an angiogram 20 years ago and had a minor stroke as a result. He was very lucky that he was talking to the doctor at the time, just a few hours after the intervention, so he got immediate help.















Avatar for i_florida04
iVillage Member
Registered: 01-16-2004
Thu, 03-18-2010 - 7:16am

My thoughts are they are not required w/o a dr's approval or order.

iVillage Member
Registered: 03-09-2001
Thu, 03-18-2010 - 7:11pm
No, EKGs were never part of my yearly checkup. In my experience, they are only ordered as pre-op for surgery or, I guess, if someone complains of symptoms or something, so the doctor orders one. That's only been my experience, though, so I don't know how typical that may be for others here in the U.S. Depends on the doctor and/or the health plan/insurance protocol for ordering tests, I think. Different for each health plan/insurance as well as doctors, perhaps?



Blessings,

Gypsy

)O(



Photobucket



Strong like a mountain,

Flowing like a river."

~~Tai Chi Chih



Photobucket





Photo Sharing and Video Hosting at Photobucket Photobucket



Mika Dog




"All things share the same breath;

the beast, the tree, the man.

The Air shares its spirit with

all the life it supports."

--Chief Seattle



"If there are no dogs in Heaven,

then when I die I want to go where they went."

~Will Rogers



"The greatness of a nation and its moral progress

can be judged by the way its animals are treated."

~~Mahatma Gandhi





Photobucket Photobucket






Blessings,

Gypsy

)O(



iVillage Member
Registered: 03-19-2003
Thu, 03-18-2010 - 11:55pm

Over here an complete medical, which one takes at least every couple of years, includes an ECG and sometimes a stress test, too.

If one is already seeing a cardiologist, then one can choose to have an EKG done a few minutes prior to the consultation even if the doctor hasn't ordered it. The cardiology polyclinic at the hospital our cardiologist works at has the machines, and the nurse does it. It doesn't add that much more to the cost of the visit so it's pretty much worth getting it. Sometimes there are advantages living in a developing country, and this is one of it! (Another one is that a mammogram *and* ultrasound only costs $65 at a leading private hospital, the radiologist does the ultrasound herself and bases it on the mammogram and we know the result then and there so not awful waiting).

















iVillage Member
Registered: 03-09-2001
Fri, 03-19-2010 - 8:24pm
Many here in the U.S. do not have access to medical care and insurance coverage. Nor can they afford to purchase it. Health care reform is being attempted by our gov't. But right now insurance companies control what insurance pays for and what it does not. And control what tests are covered if doctors order them. Sometimes people cannot pay for tests if they are out of pocket, so they do without. We are fortunate to have coverage through my DH's employer. Otherwise I would not have had heart surgery last year because we could not have afforded the prices to purchase insurance on our own, let alone to pay for tests or surgeries out of pocket. :O Many people have no insurance coverage and cannot afford to purchase their own or pay for care out of pocket in our country. Hopefully that will eventually change. :)


Blessings,

Gypsy

)O(



Photobucket



Strong like a mountain,

Flowing like a river."

~~Tai Chi Chih



Photobucket





Photo Sharing and Video Hosting at Photobucket Photobucket



Mika Dog




"All things share the same breath;

the beast, the tree, the man.

The Air shares its spirit with

all the life it supports."

--Chief Seattle



"If there are no dogs in Heaven,

then when I die I want to go where they went."

~Will Rogers



"The greatness of a nation and its moral progress

can be judged by the way its animals are treated."

~~Mahatma Gandhi





Photobucket Photobucket






Blessings,

Gypsy

)O(