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Expert Q&A

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Are cardiac tests equally effective in men and women?

Asked by D Schafer, California

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Are cardiac tests such as the stress echo as effective at diagnosing blockages and arrhythmia in women as they are in men?

Expert Bio Picture

Conditions Expert Dr. Otis Brawley Chief Medical Officer,
American Cancer Society

Expert Answer

I believe that cardiac tests such as the stress echocardiography, in which an ultrasound is done after exercise, or the stress thallium, in which a nuclear medicine is injected into the bloodstream and the patient exercises, are all good tests and are as effective in men as in women. There are data to suggest that women may have pain symptoms different from men and that they may be interpreted by physicians differently, but the objective tests work as well in both men and women.

When we assess a heart we are interested in a few things. The echo tells us the size of the chambers that contract to propel blood. If any part of the chamber is not contracting, which may indicate an old myocardial infarction (a portion of the heart muscle is dead). The echo is also useful in looking at the function of the valves of the heart. Electrocardiograms are useful in showing electrical conductivity in the heart. Abnormal beating or arrhythmia is best seen on a long electrocardiogram often called a rhythm strip. A 12 lead EKG can be helpful in telling us if the patient has had a myocardial infarction or has a rhythm disturbance.

The stress thallium and the cardio catheterization, in which dye is injected in the coronary arteries (arteries of the heart muscle) are both useful in telling us if there is any coronary artery disease.

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