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Cardiac PET Stress Testing

“Doctor, I had a nuclear stress test months ago, traveled on business, and 3 months later suffered a heart attack! How can that happen?”

There are many misperceptions regarding stress testing and what the results guarantee. Tests in general can either be good at picking up abnormal patients or correctly identify normal patients. You can’t have it both ways, until now!

Stress echocardiogram and nuclear stress testing have been the norm for years. These tests are used to identify patients with significant blockages that need immediate attention. Hopefully, at the same time we don’t misidentify healthy patients and send them off for unnecessary and potentially dangerous additional testing. For those of you who remember statistics, the sensitivity of these tests vary in studies between 80% and 90%. Specificity is worse at 75-88%.

The “GOLD STANDARD” to assess how well stress echocardiograms and nuclear testing is doing has been Cardiac PET testing. Used primarily as a research tool this “GOLD STANDARD” has been unavailable to patient care until recently. Previously, one needed a cyclotron to obtain the nuclear isotope, rubidium-82, for PET imaging. We now have the ability to bring the rubidium-82 to the office of a nuclear cardiologist using a generator that produces rubidium-82 (from decaying strontium) for one month. In addition, equipment is more reasonably priced allowing nuclear cardiologists to offer the “GOLD STANDARD” in their office.

Cardiac PET testing offers a sensitivity of 93% meaning we correctly pick up 93 out of 100 patients that have significant plaque. Specificity, correctly identifying normal patients is 92%, thus only misdiagnosing 7 out of 100 patients that are normal. Unusual anatomy, such as congenital heart disease, artifacts from coughing, talking or sleeping during the test and differing thickness of ones heart especially at the apex or tip, are some of the major reasons even this test is not perfect.

Please CLICK HERE to read the brochure on Cardiac PET testing and feel free to discuss the appropriateness of PET testing with your physician or with Heart First. In summary, patients that have equivocal testing or coronary CTA that indicates borderline obstructive plaque in the 50-70% range would benefit from the “GOLD STANDARD”. Patients that are significantly overweight or unable to exercise on a treadmill should consider Cardiac Pet as initial testing.

HeartFirst is one of the first outpatient centers in Texas to offer the “GOLD STANDARD” in the office. Don’t settle for tests that may miss significant blockages or tell normal patients that they incorrectly need help. Please call with any questions or consult with a Heart First provider to discuss the specifics of your case.

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