Ask the doctor: Is a nuclear imaging stress test the same thing as an exercise stress test or exercise echocardiogram?

Ask the doctor

Is a nuclear imaging stress test the same thing as an exercise stress test or exercise echocardiogram?

Q. I had some vague chest pain on vacation and went to the emergency room. The doctor told me to have a nuclear imaging stress test when I got home. My primary care physician sent me to a cardiologist for a treadmill test. But the cardiologist had me do an exercise echocardiogram on a bicycle. Are these tests the same? Why is everyone telling me that I need a different test?

A. These are all different tests, each with its own pluses and minuses. The nuclear imaging test can take hours and requires injecting a small dose of a radioactive tracer into the bloodstream to measure blood flow. The standard treadmill test is fast, easy, and inexpensive, but it relies on changes in the electrocardiogram to make a diagnosis, so it isn't that helpful in people who already have abnormal electrocardiograms. The exercise echocardiogram, which can be done on a treadmill or bicycle, takes pictures of the heart before, after, and sometimes during exercise.

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