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Advanced Tests Not Always Needed to Uncover Heart Disease

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Posted: 6/5/2012

​COLUMBUS, Ohio – Despite the age of the technology, exercise stress tests remain an extremely useful and cost-effective method for detecting heart disease during a period when many doctors opt for high-tech and often high-cost testing, according to an Ohio State University Wexner Medical Center cardiologist.

For heart patients like Barbara Current, the life-saving test she needed was an older technology stress test that revealed vital information that had been elusive with more modern testing procedures.

After imaging failed to show why Current was experiencing pain and an anxious feeling her chest, her physician looked at the results of Current’s exercise stress test.

“The exercise stress test saved my life,” said Current.

Dr. Martha Gulati, Current’s physician, knew a cardiac catheterization was needed based on the abnormal stress test. She recently authored a paper on this topic, which was recently published in Current Problems in Cardiology.

“Using imaging with stress testing is important and useful, but it is often overused, exposing patients to unnecessary radiation and driving up health care costs,” said Gulati, director of preventive cardiology and women’s cardiovascular health at The Ohio State University Wexner Medical Center. “In addition, even where imaging is used, important information that comes from the exercise stress portion is often ignored.”

In cases where a patient can only perform the stress test for a few minutes, they might need a different test to get the correct results, so Gulati says it’s all about the using the right test for the right patient.

Stress tests are the most commonly ordered noninvasive test for coronary heart disease, but traditionally, physicians look at one main variable, the appearance of ST depressions on the electrocardiogram (EKG).  The ST segment is part of a normal EKG tracing. When it becomes depressed with exercise, it may indicate coronary artery disease.  According to Ohio State researchers, other data obtained from the stress test can also be valuable to a physician diagnosing heart disease.

Dr. Kavita Sharma, co-author of the review of the research, said exercise capacity, heart rate, blood pressure response and chest pain are all examples of other powerful data that can be obtained from an exercise stress test to help identify coronary artery disease and even help predict risk of death.

“All this data is readily available on a traditional exercise stress test. The interpreter just needs to fully examine it,” said Sharma, assistant professor of clinical medicine at The Ohio State University Wexner Medical Center.

According to Gulati, stress tests can give physicians important predictive information for patients, not just about their immediate health or their current status of coronary disease, but also information that might help predict their risk of developing heart disease in the future.

 

Gula

ti and Sharma hope their research will help patients feel empowered to ask why a test is being ordered and ask if it includes radiation to ensure the benefit outweighs the risk.

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Contact: Gina Bericchia, Medical Center Public Affairs & Media Relations, 614-293-3737 or Gina.Bericchia@osumc.edu

Ross Heart Hospital; Heart Disease; OSU Medical Center