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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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History Of Heart Attack. Angiograph Shows Blocked RCA. Will Stress Thallium Test Help?

My father age 69yrs, had heart attack some 10 years back and then he got stent in center artery. Recently from angiograph, doctor found RCA is fully blocked, but blood is seen on either side of blockage. Left one has some 60%+ blockage. That center one with stent have some blockage little farther from stent position. So suggested Bypass. As such my father is doing fine, so he is not agreeing for By pass. He takes his medicine regularly. Now some one suggested Stress Thallium test. Will it serve any purpose, post angiograph done recently ? Any alternative. One of his doctor, suggested in that case, it may go for stent in RCA which shows full block. Any comment.
posted on Mon, 22 Apr 2013
Twitter Tue, 23 Apr 2013 Answered on
Twitter Tue, 23 Apr 2013 Last reviewed on
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Cardiologist,  's  Response
If your father is asymptomatic with his level of daily activity, on good medications for the heart, then there is no role for coronary interventions; a stress test would not be useful either. Results from a huge recent trial called COURAGE indicate that stable patients with chronic stable coronary artery disease can do really well with medications.

To the second question, there is no role to do a stress test now after the recent diagnostic angiogram, it is like trying to climb a tree by sliding down.

Hope this helps

Dr Brenes-Salazar
Mayo Clinic Rochester
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History Of Heart Attack. Angiograph Shows Blocked RCA. Will Stress Thallium Test Help?

If your father is asymptomatic with his level of daily activity, on good medications for the heart, then there is no role for coronary interventions; a stress test would not be useful either. Results from a huge recent trial called COURAGE indicate that stable patients with chronic stable coronary artery disease can do really well with medications. To the second question, there is no role to do a stress test now after the recent diagnostic angiogram, it is like trying to climb a tree by sliding down. Hope this helps Dr Brenes-Salazar Mayo Clinic Rochester