Baran
Kilical, MD
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» A AMC MAGA Z I N E | W I N T E R 2 014
Choosing Wisely promotes conversations between
physicians and patients by helping patients choose care
that is:
››
supported by evidence
››
not duplicative of other tests or procedures already received
››
free from harm
››
truly necessary
These recommendations are meant to spur conversation
about what is appropriate and necessary treatment. As each
patient situation is unique, physicians and patients should
use the recommendations as guidelines to determine an
appropriate treatment plan together.
It’s important to know whether a test is really
necessary. Visit
askAAMC.org/choosingwisely
to learn
which tests you should question.
Imaging stress tests take pictures of the heart while it is working
hard. Ultrasound and echocardiography tests take pictures with
sound waves. Nuclear cardiology tests use a small amount of a
radioactive substance to get pictures.
“You may need an imaging stress test if you have symptoms
of heart disease, such as chest pain, shortness of breath,
irregular heartbeats, or heart palpitations, which are unusually
strong heartbeats,” says Baran Kilical, MD, cardiologist and
electrophysiologist at AAMC. “Or you may
need one if you already have heart disease or
if you have a high risk for heart disease. These
tests can help your doctor decide the best
treatment for you.” But if you are a healthy
person without symptoms, you should think
twice about having these tests. Here’s why:
The tests aren’t always useful
An imaging stress test is best used to manage severe heart disease.
The test can help your doctor find out if blood flow to your heart
is blocked. It can also show where any suspected blockages are
and how severe they are. It can help you and your doctor make
decisions about treatment. However, if you are at low risk and
don’t have symptoms, the test has limited benefits.
The tests can lead to others that are not needed or risky
An imaging stress test is usually safe and can be done using little
or no radiation. But the test can cause anxiety. And it can lead to
other tests and treatments that do have risks.
For example, if something looks wrong on the imaging stress
test, your doctor may order a CT Scan and an angiogram. These
expose you to radiation. Risks from radiation exposure can add
up, so it is best to avoid it when you can. Excess testing can lead
to unnecessary treatment with drugs as well.
The tests can cost a lot
An imaging stress test costs between $500 and $2,000. Since the
tests can provide more information than routine stress tests, they
may be worth it. But if you don’t need one, why spend the money?
The tests should be used only when they will help you and your
doctor treat and manage your disease.
When You Need Them and When You Don’t
Choosing Wisely
A free
High Blood Pressure
booklet can
help you take control to protect your health.
Visit
askAAMC.org/magazine
or call
443-481-5555
or to request yours today.
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Be part of the conversation at our March docsTALK show. Learn how to make the most of medical appointments. See the back page for details.
What is Choosing Wisely
®
?
Imaging Tests
for Heart Disease
