Question:
Last year February 2000, I went to a new doctor for my annual checkup.
He also specializes in cardiology. I had told him that I had some
tightness around my chest. I also told him that it might have been
caused by some pushups that I started doing again. He gave me a stress
and echo test. The tests showed no problems.
I just saw him again and he strongly suggesting that because of my age
(54) I should take the stress and echo test annually. My insurance will
cover the tests. But it will cost me 2 to 3 hours and out of principal,
I don't want to take the tests, if I don't need them.
Professional opinion, please?
Answer:
Take the test.
Always get a second opinion in a situation like this, even if you have
to pay for the consultation out of pocket.
I asked my doctor if I could take a stress test at age 45 because my
father had a heart attack when he was 46. My doctor said all the
exercise I do was stress test enough and that there was no point in a
traditional stress test. He told me about a relatively new procedure
called a Fast CT Scan for Coronary Calcium that I elected to have done -
it cost me about $400 out of my own pocket. This test is supposed to be
worthwhile for people who have no symptoms but do have risk factors. It
looks for calcium buildup in your coronary arteries, and since the stuff
that clogs them is largely calcium, it's supposed to be an excellent
predictor of future cardiovascular problems, at least those associated
with reduced blood supply to the heart because of arterial plaque (sp?)
buildup. (A lower score is better on this test and I scored a
resounding _zero_.)
No point in him having a record of your performance, for checking
whether or not your exercise plan is appropriate for your the
condition of your c/v system.
I guess I need to put this in perspective. I do enough exercise that
it's arguably inappropriate for anyone's "c/v" system. Swim, bike, run,
tae kwan do, weight lift, kettlebells, all several times each week, thus
I think he looks at me and sees that I push my body from just about
every possible perspective already.
I understood, without the detail, that you exercise strenuously. I
don't see where a cardiologist would see that this "trial by error"
would be comparable to a stress thallium in his office, charted for
his and your records. The fact that you have such an rigorous exercise
regimen would be a strong reason to have it, not to skip it. Maravich
was hypertrophic; a simple echocardiagram and stress might have saved
his life. I have mine coming up mid-April and my exercise levels are
high too. I am about ready to introduce morning swimming and before I
do, I want to have a reasonable degree of assurance that getting in
better shape won't kill me.
