Is nuclear stress test necessary?

Questioning your doctor about a test he has ordered is uncomfortable for some people, but most doctors don’t feel threatened by a respectful request to explain our reasoning.



March 4, 2020 - 10:03 AM

Dear Dr. Roach: I am a 69-year-old male who underwent bypass graft surgery in late 2014. I have been free of symptoms since. I exercise daily by walking and/or cycling, maintain a healthy diet and have never smoked. I’m 5 feet, 7 inches tall and weigh 152 pounds. I’ve been on once-daily statin and metoprolol since the bypass. BP and cholesterol numbers have stayed normal, and I have no other health issues. 

Dr. Keith Roach

My cardiologist has scheduled me next month for a carotid ultrasound, echocardiogram and a nuclear cardiac treadmill stress test in what he describes as a routine five-year follow-up to my bypass procedure. I’m concerned mainly about the nuclear stress test. I read an article by the American Society of Nuclear Cardiology that stated such a test is rarely necessary in the absence of symptoms. Plus, it exposes one to radiation and may lead to false positives and further unneeded testing, which is said to be more likely to occur in a symptom-free patient. I was not aware of this fuller context when this test was scheduled. Would it be prudent for me now to question my doc about whether this test is really needed? — K.B.

Answer: I agree with you completely.

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