Stress Test Can Miss Heart Disease

56% of those who passed then flunked scan for hardening of arteries

TUESDAY, Aug. 17, 2004 (HealthDayNews) -- Standard exercise stress tests may not detect latent hardening of the arteries, says a Cedars-Sinai Medical Center study in the Aug. 18 issue of the Journal of the American College of Cardiology.

The results suggest that additional screening for coronary calcium using X-ray computed tomography (CT) scanning could prove useful even when patients have normal stress test results. As deposits of calcium rise in heart arteries, so too do risks for heart attack.

"A relatively high number of patients who had normal readings on their stress tests had a calcium score of greater than 100, a score that is accepted as implying the need for aggressive medical treatment," Dr. Daniel Berman, director of cardiac imaging at the S. Mark Taper Foundation Imaging Center at Cedars-Sinai, said in a prepared statement.

He and his colleagues tracked 1,195 patients without any known heart disease. They underwent stress testing, followed by coronary calcium scanning. Of the 1,119 patients who had normal stress test imaging test results, 56 percent had coronary calcium scores of more than 100 and 31 percent had scores of more than 400.

"Our study shows that patients who have normal imaging stress test results frequently have extensive atherosclerosis [hardening of the arteries] as revealed by coronary calcium scanning," Berman said.

"These findings imply a potential role for the coronary calcium scan, after an imaging stress test among patients whose results are normal. These patients could then be identified as needing an aggressive treatment program of diet, exercise and medications -- something which they often would not otherwise get based upon standard blood tests and the imaging stress test results alone," he said.

More information

The American Heart Association has more about atherosclerosis.

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