Lexiscan Nuclear Stress Test Alternatives

My cardiologist wants me to take a Lexiscan Nuclear Stress Test. I had a dual chamber pacemaker implanted a year ago for complete AV heart block with no other known heart conditions at the time. My device is a Medronics W1DR01 Azure XT DR.
Initially (at my annual check last year) He did not feel that the scan was needed beacause my CT scan score was 9 from 2-3 years ago and I had no symptoms. I let him know that my endurance level was reduced since the PM implant. I don't
work out as much due to the pandemic, my walking endurance is at 85-90%, biking endurance about 50%. After hearing that He recommended the nuclear scan test. My endurance has been improving with more activity. I plan to discuss my endurance
with the Electrophysiologist in a few weeks.

I have concerns about taking the test due to radiation exposure and the drugs (Lexiscan) used to stress the heart,and the radioactive liquid (tracer).

 

https://www.fda.gov/drugs/drug-safety-and-availability/fda-warns-rare-serious-risk-heart-attack-and-death-cardiac-nuclear-stress-test-drugs-lexiscan

Are there safer alternatives that offer the same benefits with less radiation and drug risks? Why do I need the drugs to stress the heart and not exercise? I ride a bike 3 days a week. I am not a diabetic.

I'm looking into a Heart PET scan, or Heart flow analysis.

I understand that Cardiac PET/CT provides improved accuracy, less radiation and increased efficiency in the detection of coronary artery disease compared to current modes of nuclear stress testing (SPECT).


Any opinions or experiences would be appreciated.


5 Comments

stress test

by new to pace.... - 2022-05-07 20:34:56

know your concerns about putting more drugs into our systems.  All  3 of my stress tests have been done with the Lexiscan Nuclear stress test.  Instead of using a treadmill.  I found i did not have any trouble with the chemicals that are used for this test.  the last one was done differently then the first 2.

new to pace

Lexiscan

by Julros - 2022-05-07 21:02:29

I am not aware of any dye used during  a Lexiscan. A radionucleotide is injected, and a medication similar to adrenaline is used to mimic exercise. Both are quickly eliminated from your body. You likely have more radiation exposure from the sun. As a female, I can say that I prefer the chemical stressor to running braless on a treadmill. I've not had a cardiac PET scan, but my son has had one and found it quite unpleasant. 

Lexiscan

by AgentX86 - 2022-05-07 22:17:45

Thanks Julros, just what I needed to hear. Both my wife and I are having PET scans next Thursday.

As far as "chemicals" and "radiation" go, they make great scare words. By themselves, the words are pretty meaningless. The question is what, what if,  and what if not. IOW, what is the "chemical " or "radiation" type and ammount. More importantly, what is the risk and what is the reward. Everything has a risk, including doing nothing.

Your doctor clearly believes that the reward for these tests exceeds the reward. It's certainly worth asking about the other tests but he may not believe they'll show what he wants to know or the cost of the procedure can't be justified in your case.

My cardiologist is doing PET scans on us more as a screening than anything else. It's been seven years since my CABG, so wanted to make sure every everything is still good. We're 70, so my wife gets to join in the fun. She was just diagnosed with first degree heart block (cardiologist didn't think it was worth mentioning) so came across his radar. ;-)

PET scan

by Julros - 2022-05-07 22:26:34

For my son who is a Type 1 diabetic, the unpleasantness was related to being restricted to no sugar before scanning, from midnight before the procedure. He was stricken with hypoglycemia and was concerned about potential seizures and coma. 

PET

by AgentX86 - 2022-05-09 12:12:59

Thanks Julros,

Your comments make sense now. I'd read up on the test and it didn't seem to be a big deal. I can see how diabetes could complicate things, like it does so many times. My wife is a type two but I think she'll be alright. She goes first because they want to do echoes on the heart, descending aorta, and legs. I have an echocardiogram done regularly.

We'll get done about the same time so we go can find a cow to eat.

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