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$Title{Stress Test and Family History of Heart Disease}
$Subject{stress test heart exercise Special Procedures procedure Laboratory
lab Tests treadmill stationery bicycle angiogram}
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Copyright (c) 1991-92,1993   Tribune Media Services, Inc.


Stress Test and Family History of Heart Disease


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QUESTION:  I've never had chest pains, but my father's family has a history of
heart disease, and he recently had a heart attack.  Should I now go for a
stress test?

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ANSWER:  Unless you have personally had signs of heart disease, you probably
do not need an exercise stress test.  But since there is a history of heart
disease in your family, you might want to discuss the possibility with your
doctor.
     Your doctor should analyze your risk factors.  For example, if you have a
high cholesterol level, drink excessive amounts of alcohol or coffee, or are
overweight, your risks of heart disease are elevated.  The stress test may
then provide significant prognostic information.
     The exercise stress test is done by monitoring the patient's heart as he
or she walks on a treadmill or uses a stationery bicycle.  When done properly,
it can be one of the most valuable noninvasive tests.  But, if your doctor's
analysis of your risk factors leaves him to believe you have a low probability
of heart disease, the test may just put you several hundred dollars out of
pocket without gaining useful information.  If you disagree with your doctor's
advice against having the test you might seek a second opinion, but the best
way to help yourself and your heart is to strive to reduce your risk factors.
     In our new society of exercise enthusiasts, there has been a widespread
misconception that stress tests are a must for anyone who is planning to
embark on an exercise program.  The problem with these tests is that there has
been a high incidence of false-positive results.  If a patient has been under
unusual tension or emotional stress or is on medication, the results may be
altered.  Some patients even eat prior to the test despite instructions not
to, and this too can lead to a false-positive result.
     For all these reasons, some researchers are now stating that routine
screening is inadvisable.  If the test is warranted, and it shows a
probability of heart disease, the physician must then decide whether to allow
the patient to do active exercise or to prohibit it, or perhaps develop a
modified exercise program.  An angiogram (x-ray technique which reveals the
condition of coronary arteries) may be necessary.  If the angiogram is
negative, it can rule out life-threatening coronary artery disease, while a
positive angiogram may point to the need for surgery in a high risk patient.
As you can see, there are many important facets to your question, and a sit
down discussion with your family doctor is indicated.

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The material contained here is "FOR INFORMATION ONLY" and should not replace
the counsel and advice of your personal physician.  Promptly consulting your
doctor is the best path to a quick and successful resolution of any medical
problem.