This confirms what I heard that heart attacks can happen in places where there is little blockage. This is why stents are only recommended for severe blockages. But let's say a plaque rupture happens at a places with minimal blockage (i.e. plenty diameter left). Is it possible that the resulting clot will form without obstructing completely the artery and then it is later reabsorbed by the body without much of a symptom? Whereas if it happens at a place with severe blockage, even a tiny clot will cause an attack? I am asking this because I keep hearing that one should not rush to stent a blockage even if severe as long as symptoms (angina) are controlled with medication.
While stents are generally recommended only when the degree of blockage in an artery exceeds 70%, most heart attacks happen in arteries that are less than 50% narrowed. In many cases, heart attacks may even happen in arteries with no significant narrowing at all. The culprit is rupture of the surface of the plaque which causes a clot to form at the site of the plaque rupture. The vast majority of the time the clot that forms is either too small to completely block the artery or it dissolves before any significant damage has occurred. Heart attacks very likely occur in only a very small fraction of the plaque ruptures. While narrowing of the artery can occur again after placing a stent, the goal of the stent is to restore a normal diameter to the artery. Therefore, an artery that has been stented should not be much more susceptible to being blocked by a small clot than if there had not been a stent there in the first place. The bigger issue is that studies have shown that stents are effective at reducing angina symptoms but are much less effective at preventing heart attacks because the stent treats only a very small segment of one artery. Since plaque is usually present throughout the coronary arteries, there is still a risk of plaque rupture causing a heart attack in the remaining segments of the arteries other than where the stent is at. Medical therapy with lifestyle changes, statins, aspirin, etc., turns out to be more effective than stents at preventing attacks. If the main use of a stent is to treat angina and the angina is well controlled with medication there is less need for the stent.
It sounds then that this test is rather, useless because of its' lack of sensitivity to all but the most severe cases and, those cases will cause very easy to recognize symptoms that require no costly test at all. In other words, the nuclear Stress test (such as what I had today) is a big waste of money.
A myocardial bridge is when a portion of heart muscle overlaps the coronary artery that normally sits on the surface of the heart. It is rare but can cause a narrowing of the artery. The underlying principles remain the same- unless the narrowing is greater than 70% it will not likely show up on a stress test. It is also unlikely to cause exertional symptoms. Myocardial bridges are not likely to cause plaque rupture or heart attacks but can cause angina. However, the point is that stress tests are good for finding out if chest pain is angina due to arterial obstruction but are not good for finding out if you are at high heart attack risk from plaque.
Si I have left side chest pain since 1.5 year what it could be heart related ? I had ever Anxiety attack in 2019 Feb. Is there any link of pain cause of Anxiety? Not pain in running walking but feel when laying on bed and rest time ...kindly reply with Regards
Hi Usman! Unfortunately it is not accurate or ethical to speculate on chest pain without examining you as a patient and running tests. Chest pain should always be thoroughly evaluated by a physician. If you have not already sought the help of a doctor - please do so immediately.
@@PrincetonLongevity I had recently done ETT and ECHO test they r all normal even I had done other test like TROPT lipiprofile by many times doctor said it seems like anxiety or spondilites pain or Gastro ...let c
@@UsmanAli-si7rz Without ever seeing you as a patient for a full medical history and hands-on examination it is inaccurate and unethical to provide medical advice. Please speak to your physician or seek the assistance of another physician for a second opinion.
@@PrincetonLongevity thank you very much for such a good advise Even this is my second opinion first doctor told me for Angiography but 1.5 or more old chest pain can be a heart related?
Hi Adam - thank you for bringing that information (or lack thereof) to our attention. We are talking about a Coronary Artery Scan or Coronary Calcium Scoring done with high-definition CT. This is the best non-invasive test to identify your risk of heart attack. Please let us know if we can answer anything else!
Princeton Longevity Center - Thank you for the details. I am sitting in the cardiologist now waiting to be called for my first "stress test." I have not had chest pain, just a variable heart rate i.e. 30-50 bpm increase from sitting to standing. Guess I see in a few hours if it was a waste of time or not. :)
I had chest pain and shoulder pain from 2 months I had tested Echo, Tmt, x-ray, Holter, EcG all test are normal Dr said but till now I have chest pain shoulder pain and also I feel pain while walking what to do about it please tell me..
Hi Sangey, While I can understand your concern - it is not appropriate or ethical for us to comment on how your care should proceed without ever having evaluated you personally. You should continue seeking care from your physician or emergency room and we are happy to discuss scheduling an appointment for you at our center in addition to your current treatment so that we can better discuss your treatment plan.
Hi Kuch- thank you for your question. Stress tests generally require a significant blockage causing reduced blood flow to read as positive. Our point is not to say that this test can assess your minimum blood flow - our point is to say that stress tests are a poor way to predict heart attack RISK. They are really for determining who might need invasive cardiac intervention to fix a problem. Cardiac CT is the better way to evaluate the heart for risk of heart attack so that early and less invasive intervention can be used to prevent a future heart attack. We're happy to answer your questions about the testing at PLC or our expertise in Preventive and Executive Medicine. Please feel free to call us at (888) 8000-PLC or email your questions to info@theplc.net. We look forward to hearing from you!
My stress Test (T.M.T.) done on Dt. 6/6/2019.. is Negative.. Yet my Cardiologist advised me for.. M.P.S. test.. I am a Heart Patient.. and an Angioplasty was done on Dt.27/10/2017.. Please give me Guidance in this matter.. Thank you.. Sir..
Hi Uttam - thank you for your question. Without knowing your full medical history and having examined you as a patient - it would be both inaccurate and unethical to provide medical advice regarding your specific situation. We're happy to answer your questions about the testing at PLC or our expertise in Preventive and Executive Medicine. Please feel free to call us at (888) 8000-PLC or email your questions to info@theplc.net. We look forward to hearing from you!
Great explanation, does a calcium score test give a good indication of plaque buildup in the heart area ?
This confirms what I heard that heart attacks can happen in places where there is little blockage. This is why stents are only recommended for severe blockages. But let's say a plaque rupture happens at a places with minimal blockage (i.e. plenty diameter left). Is it possible that the resulting clot will form without obstructing completely the artery and then it is later reabsorbed by the body without much of a symptom? Whereas if it happens at a place with severe blockage, even a tiny clot will cause an attack? I am asking this because I keep hearing that one should not rush to stent a blockage even if severe as long as symptoms (angina) are controlled with medication.
While stents are generally recommended only when the degree of blockage in an artery exceeds 70%, most heart attacks happen in arteries that are less than 50% narrowed. In many cases, heart attacks may even happen in arteries with no significant narrowing at all. The culprit is rupture of the surface of the plaque which causes a clot to form at the site of the plaque rupture. The vast majority of the time the clot that forms is either too small to completely block the artery or it dissolves before any significant damage has occurred. Heart attacks very likely occur in only a very small fraction of the plaque ruptures. While narrowing of the artery can occur again after placing a stent, the goal of the stent is to restore a normal diameter to the artery. Therefore, an artery that has been stented should not be much more susceptible to being blocked by a small clot than if there had not been a stent there in the first place. The bigger issue is that studies have shown that stents are effective at reducing angina symptoms but are much less effective at preventing heart attacks because the stent treats only a very small segment of one artery. Since plaque is usually present throughout the coronary arteries, there is still a risk of plaque rupture causing a heart attack in the remaining segments of the arteries other than where the stent is at. Medical therapy with lifestyle changes, statins, aspirin, etc., turns out to be more effective than stents at preventing attacks. If the main use of a stent is to treat angina and the angina is well controlled with medication there is less need for the stent.
Very helpful information in this video. Thanks Princeton Longevity Center.
It sounds then that this test is rather, useless because of its' lack of sensitivity to all but the most severe cases and, those cases will cause very easy to recognize symptoms that require no costly test at all. In other words, the nuclear Stress test (such as what I had today) is a big waste of money.
thank you! Only way to tell is with this test
EKGs and Stress tests do NOTHING except show electircal heart problems
Oh man white thus kinda bites. I just did a stress test was hoping that it would show even if small blockage.
What is a false positive result from a stress test?
What about narrowing due to myochordial bridge?
A myocardial bridge is when a portion of heart muscle overlaps the coronary artery that normally sits on the surface of the heart.
It is rare but can cause a narrowing of the artery.
The underlying principles remain the same- unless the narrowing is greater than 70% it will not likely show up on a stress test. It is also unlikely to cause exertional symptoms.
Myocardial bridges are not likely to cause plaque rupture or heart attacks but can cause angina.
However, the point is that stress tests are good for finding out if chest pain is angina due to arterial obstruction but are not good for finding out if you are at high heart attack risk from plaque.
Si I have left side chest pain since 1.5 year what it could be heart related ? I had ever Anxiety attack in 2019 Feb. Is there any link of pain cause of Anxiety? Not pain in running walking but feel when laying on bed and rest time ...kindly reply with Regards
Hi Usman! Unfortunately it is not accurate or ethical to speculate on chest pain without examining you as a patient and running tests. Chest pain should always be thoroughly evaluated by a physician. If you have not already sought the help of a doctor - please do so immediately.
@@PrincetonLongevity I had recently done ETT and ECHO test they r all normal even I had done other test like TROPT lipiprofile by many times doctor said it seems like anxiety or spondilites pain or Gastro ...let c
@@UsmanAli-si7rz Without ever seeing you as a patient for a full medical history and hands-on examination it is inaccurate and unethical to provide medical advice. Please speak to your physician or seek the assistance of another physician for a second opinion.
@@PrincetonLongevity thank you very much for such a good advise Even this is my second opinion first doctor told me for Angiography but 1.5 or more old chest pain can be a heart related?
So Usman how u feel now, did u find out what was z prob... I guess I have z same symptoms and tomorrow have stress test
You kept mentioning "Scan" though didn't specify what type of "scan". I assume you meant echocardiogram. Would this be correct?
Hi Adam - thank you for bringing that information (or lack thereof) to our attention. We are talking about a Coronary Artery Scan or Coronary Calcium Scoring done with high-definition CT. This is the best non-invasive test to identify your risk of heart attack. Please let us know if we can answer anything else!
Princeton Longevity Center - Thank you for the details. I am sitting in the cardiologist now waiting to be called for my first "stress test." I have not had chest pain, just a variable heart rate i.e. 30-50 bpm increase from sitting to standing. Guess I see in a few hours if it was a waste of time or not. :)
What does two day Lexi scan mean
@@mitsured so what happened?
@trent o nothing was found. My doc put me on a low dose of atenolol. This has helped with my heart rate.
I had chest pain and shoulder pain from 2 months I had tested Echo, Tmt, x-ray, Holter, EcG all test are normal Dr said but till now I have chest pain shoulder pain and also I feel pain while walking what to do about it please tell me..
Hi Sangey,
While I can understand your concern - it is not appropriate or ethical for us to comment on how your care should proceed without ever having evaluated you personally. You should continue seeking care from your physician or emergency room and we are happy to discuss scheduling an appointment for you at our center in addition to your current treatment so that we can better discuss your treatment plan.
@@PrincetonLongevity it can be heart related iam 29 years old
@@sangeynguedang6894 We simply have no way of knowing without physically examining you.
@@PrincetonLongevity Thank u for your reply sir.15 days ago I had done my test
I stay in a small town so here no cardiology available.i have to go far for check up
If I hv negative tmt test so does dat mean i have minimum 30℅ blood flow.?
Hi Kuch- thank you for your question. Stress tests generally require a significant blockage causing reduced blood flow to read as positive. Our point is not to say that this test can assess your minimum blood flow - our point is to say that stress tests are a poor way to predict heart attack RISK. They are really for determining who might need invasive cardiac intervention to fix a problem. Cardiac CT is the better way to evaluate the heart for risk of heart attack so that early and less invasive intervention can be used to prevent a future heart attack. We're happy to answer your questions about the testing at PLC or our expertise in Preventive and Executive Medicine. Please feel free to call us at (888) 8000-PLC or email your questions to info@theplc.net. We look forward to hearing from you!
My stress Test (T.M.T.) done on Dt. 6/6/2019.. is Negative..
Yet my Cardiologist advised me for.. M.P.S. test..
I am a Heart Patient.. and an Angioplasty was done on Dt.27/10/2017..
Please give me Guidance in this matter..
Thank you.. Sir..
Hi Uttam - thank you for your question. Without knowing your full medical history and having examined you as a patient - it would be both inaccurate and unethical to provide medical advice regarding your specific situation. We're happy to answer your questions about the testing at PLC or our expertise in Preventive and Executive Medicine. Please feel free to call us at (888) 8000-PLC or email your questions to info@theplc.net. We look forward to hearing from you!