Sorry, America. Your mild chest pains can be diagnosed just as easily with an older treadmill test than a CT scan. Yeah, I know. If you’re having chest pains, the last thing you’re thinking is, ‘hey, lets hop on the trusty treadmill.’
The risk of being hospitalized or dying is no different between CT scans and the older, walk on the treadmill stress test. Some view it as a surprise. What, the expensive CT scans are no better than the cheaper treadmill test? No way the medical industry is just trying to make money.
Not only is there money involved, you are also setting yourself up to exposed to a lot of radiation. No, you won’t be glowing, though I’ve had two CT scans and two MRIs in the past year of my head. Maybe I don’t need my iPhone flashlight for a midnight snack.
With CT scans being used for more than a decade, the US government fronted $40 million for a study to test their efficacy.
“It’s such a bad reflection on American medicine,” said one independent expert, Dr. Eric Topol of the Scripps Clinic in La Jolla, California. “Look at how much radiation they gave these poor people,” equivalent to 500 to 700 regular X-rays, he said. “That is despicable.”
Just a hunch, but I think if you go to Dr. Topol’s office, you’re getting on a treadmill.
Published in the New England Journal of Medicine, researchers followed more than 10,000 patients in the United States and Canada. All had symptoms that would suggest coronary artery disease.
Study leader, Dr. Pamela Douglas from Duke University, said the study showed prognostic outcomes were similar at the two-year followup.
Patients with chest pains end up in emergency rooms across the country. The pain can be anything from a clogged artery, which is an emergency, to indigestion. It’s at the ER where CT scans are widely used to turn around a quick diagnosis. No one is criticizing ER doctors who have to treat patients as a worst case scenario.
Now, patients that stroll into their primary care doctor with stable symptoms could benefit from the older tests. These symptoms can indicate hidden heart disease.
Coronary CT Scan Study
For the study, half the participants were given CT scans to diagnose symptoms. The rest? Doctors were allowed to give whatever test they preferred.
Ten percent of doctors chose the simplest test – the treadmill. It involves monitoring a patient’s heart via an ECG while you walk on a treadmill. No radiation is involved.
23 percent of patients received an echocardiogram, an ultrasound test that uses sound waves instead of radiation. For the remaining two-thirds? Nuclear stress tests were the order of the day. A radioactive dye is injected into your bloodstream to make the blood vessels show on imagery. It’s the costliest and involves more radiation than a CT scan.
Benefits of CT Scans
Before we burn all the CT scans for heart patients, the devices do play a pivotal role. Scans accurately guide who needed more intense follow-up testing, and aid physicians in artery opening procedures.
CT scanning “more accurately detects blockages and also more accurately excludes them,” said Duke University’s Dr. Pamela Douglas, who led the study. Deciding on a test is “a choice that doctors and patients should be making together.”
Costs of Tests
The costs of the tests vary wildly. A CT scan averages $400 (this must be in Canada, because that’s not what my claim statement said), an echo at $500, the treadmill test costs $150 and a nuclear stress test tops out at $1,132.
What does it mean? If you are being rushed to the ER in an ambulance for chest pains, expect some sort of scan. A doctor isn’t going to roll you off a gurney and on a treadmill if you dialed 911.
Those that notice some chest discomfort, patient education is the key. If you walk into your doctor, chances are you can jump on a treadmill to get a diagnosis.