Testing After Heart Procedures

When you need a nuclear stress test—and when you don’t

If you’ve had bypass surgery or a stent inserted to open a blocked artery in your heart, you may wonder if you need a nuclear stress test to see how well your treatment is working. This test takes pictures of your heart while it is being stressed. The test uses a small amount of a radioactive substance.

But if you do not have symptoms of heart disease, you usually don’t need these tests in the first few years after your procedure. Here’s why:

The test rarely shows a problem unless you have symptoms.

Chest pain and other symptoms of heart disease can return after getting bypass surgery or a stent. If that happens, a nuclear stress test can show if the area is blocked again or has a new blockage. The test can also help you and your doctor decide if you need additional medicine or another procedure.

But many people have the test every year, even if they don’t have symptoms. If you do not have symptoms, the tests rarely find a problem. Actual symptoms are the best sign of a returning heart problem.

The tests have risks.

The test is usually very safe, and it can be done with little radiation. The risk of cancer from the test is small, but it’s better to avoid the exposure to radiation if the test isn’t going to help you.

The test may show a false positive, or false alarm. This is more likely if you do not have symptoms. False alarms can cause worry and stress. They can also lead to more unneeded tests, such as coronary angiography. This test poses more risk and exposes you to more radiation.

Finally, the tests can lead to having another heart procedure. Each procedure has risks. And if you don’t have symptoms, having more procedures has not been proven to help prevent another heart attack or help you live longer.

The tests can cost a lot.

A nuclear stress test costs hundreds of dollars. A false alarm can lead to more unnecessary costs. The tests may give your doctor information if you have symptoms. But if you don’t, why waste the money? These tests should be used only when they will help you and your doctor manage your disease.

When is a nuclear stress test a good idea after a heart procedure?

You might need the test if your symptoms come back or get worse. This includes symptoms such as chest pain, shortness of breath, feeling tired, or having trouble climbing stairs.

If you don’t have symptoms, you may still need an imaging test if:

  • It has been more than five years since your bypass surgery.
  • It has been more than two years since your stent procedure.
  • You have blockages that weren’t treated during your first heart procedure.
  • You have diabetes or aggressive heart disease.

This report is for you to use when talking with your healthcare provider. It is not a substitute for medical advice and treatment. Use of this report is at your own risk.

© 2017 Consumer Reports. Developed in cooperation with the American Society of Nuclear Cardiology.