Question:
Is there any procedure that can be done as an alternative to the
thallium stress test in persons that are allergic to the thallium or
cardiolyte that is used to do the test?
Answer:
I have never personally heard of someone being allergic to thallium and
cardiolite but I guess it could happen. They might try a dobutamine
echocardiogram.
Have you really had a problem with thallium or cardiolite? There is
nothing noninvasive as accurate for CAD. A heart cath is a good way to
go if there is a high degree of probability for CAD. One can always do a
stress echo, but it is less sensitive/specific than a myocardial
perfusion scan.
I had a thallium test attempted. They first put me in the machine
and took x-rays, they then put the cardiolyte into my I.V. and had me
sit in a wheel chair to wait for my turn to go into the treadmill area.
I had been waiting about 20 minutes when i started to itch, and started
to break out into hives. I could not be still i itched so bad. I told
the nurse and all they kept saying was no you couldn't be allergic, no
one can be allergic to this is just like potassium that your body makes.
I showed them the whelps on me and they said that they see the whelps
but it couldn't be from the solution that they gave me. I had to insist
that she call my doctor. When they called my doctor they were told to
cancel the rest of the test, give me some benadryl, and send me home. I
was to follow up with my doctor.
Not just did i have a problem, i was totally disregarded when i had a
problem. The next day i called the director of nuclear medicine and told
them what happened and what i was told. I asked him if there had been
any reported incidents from the cardiolyte or the thallium. He checked
and told me that there had been a few reports of reactions to both. He
said one of the reports reflected a patient that had a drastic drop in
blood preassure, as well as reports of general itching, and one passed
out. He told me that i should never believe anyone that say that any
chemical introduced into the body doesn't have the potential of causing
problems, because it won't be true.
I have heard of people getting a rash with Cardiolite, but I've never heard of
it with thallium. Are you sure you received both radiopharmaceuticals? There
is another one that can be used called tetrofosmin ("Myoview").
Also, the order of the test is confusing to me. You must have had an injection
BEFORE having the first set of pictures. Otherwise, the camera's would not
have seen anything. You would have had the Cardiolite (or thallium), then the
resting pictures, then waited for the stress room where they would have
eventually given you another dose of Cardiolite (not thallium this time).
Under that condition, I would assume only one injection was given, since they
sent you home without finishing the test. Try to find out if you were given
thallium or Cardiolite. If Cardiolite was used than you could suggest they try
with thallium only, or with tetrafosmin. It could also be that you had a
reaction to the preservative used in the saline the Cardiolite was made with.
In that case, you would probably react to the tetrafosmin as well, unless they
made it with non-preservative saline.
A stress echocardiogram is every bit as good as a stress thallium, and
if the stress is carried out on a treadmill, there will be nothing to
inject in you. However, it must be done by someone who is experienced
at it
