Is Nuclear Imaging Or Plain EKG Better?

— -- Question: My insurance does not cover the cost of a nuclear stress test. Is this more expensive stress test with nuclear imaging better than the plain Stress test with EKG?

Answer: This is a problem sometimes when insurance companies will not cover the full expense of a nuclear stress test. It is more expensive. Then again the information is also much more specific and accurate in identifying coronary disease. You should discuss this with your doctor as well as with your insurance company. How important is that nuclear stress test?

In many cases, imaging is not necessary, and a regular old treadmill test where you just look at the EKG is enough. This is especially the case if you're a healthy person and you're beginning exercise and you want to be sure that you're healthy, if you're about to undergo some form of a surgical procedure which is not a very risky procedure, and your doctor wants to be certain that you have good stamina and good endurance and that you're in good shape.

In some cases though, the nuclear test is much more accurate, and therefore more important, if we, for example, are trying to define how severe coronary disease is in someone who already has coronary disease. So if you've had a heart attack or had bypass surgery or are having symptoms that strongly suggest coronary disease, then many times, imaging does give added value, and that's why your doctor ordered that test.

And so discuss it with a physician; if he or she feels strongly that this is a test you need, I would go back to the insurance company and have a discussion with them. Most insurance companies will cover this, if you have good data from your doctor that this is really necessary and the information he or she wants just can't be achieved with a regular stress test.

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