Harvard Heart Letter

Ask the doctor: Are there radiation-free tests for checking my arteries?

Ask the doctor

Are there radiation-free tests for checking my arteries?

Q. Are there any noninvasive, radiation-free tests that can give a doctor the same information about possible blockages in my coronary arteries as a nuclear stress test? I've had so many CT scans for other conditions that I'd prefer to go non-nuclear for a while.

A. You are right to be concerned about the amount of radiation you get from medical tests and to get only those tests you need. Advances in imaging have dramatically improved diagnosis and treatment in cardiology and most other branches of medicine. Yet the tests that use substantial doses of radiation, such as CT scans, nuclear stress tests, and coronary angiography, can add to the lifetime risk for cancer.

The choice of noninvasive tests for detecting or following coronary disease varies from practice to practice. It also depends on the circumstances of each patient. For many people, a standard exercise treadmill test with no imaging is a safe and reasonable approach to identifying blockages in the coronary arteries. If your doctor feels that imaging is necessary, a stress test with echocardiography is an option. It uses sound waves to "see" the heart, and there is no evidence that sound waves pose any risk to the heart or the rest of the body. A number of studies have indicated that echocardiographic and nuclear imaging provide similar prognostic information. That said, different institutions and doctors have different levels of expertise and comfort with these tests.

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