Re: both ct scan and thallium stress test?



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Topic: Religions > Atheism
User: "Andrew B. Chung, MD/PhD"
Date: 06 Nov 2006 01:04:51 AM
Object: Re: both ct scan and thallium stress test?
Kumar wrote:

Joe Doe wrote:

In article <n4b2k2ljdkc4j1rq1q7burp04plah5u42f@4ax.com>,
Jim Chinnis <jchinnis@SPAMalum.mit.edu> wrote:

"mdb" <milo_dhuey@yahoo.com> wrote in part:

My cardiologist has recommended that I have both a thallium stress test and
a CT scan of the heart, to rule out any heart problems for me. The reason
for the tests is that my brother, 3 yrs older than me at 58, recently had a
heart attack and subsequently had triple bypass surgery. It seems to me that
the CT scan would give a better answer about possible calcification and
would eliminate the need for the stress test. I'm trying to keep costs down
while still getting an accurate picture of my heart. Does anyone know if
both tests really are necessary?

thanks.

Michael


The ct scan shows only calcified plaque. The thallium test can detect
uncalcified (and probably more dangerous) plaque. I think that sometimes the
ct is done first. if it is really clear, there may be little probability of
major plaque buildup that the thallium would detect. The combination of
tests definitely gives a better picture than either alone.
--
Jim Chinnis Warrenton, Virginia, USA



The thallium will detect a reduction of flow and is a functional test
(it is reporting reduction in flow and does not really distinguish
vulnerable from non vulnerable plaque). Only IVUS will report
vulnerable plaque. Unfortunately, you need the reduction in flow to be
quite significant for it to show up in the thalium stress test.

The cardiologist is proposing a test that could detect low levels of
calcified plaque and a functional test that would be sensitive to
significant blockage. If you have led anywhere close to a normal
American life it is a fairly good bet that you have some degree of
coronary artery disease (and will score positive on the calcium
scoring). As Jim pointed out, the calcified plaque is generally more
likely to cause angina and physical discomfort rather than sudden death
or MI which vulnerable soft non-calcified plaque will cause.

At the current moment in time, none of the non-invasive tests are all
that great. They are simply so so screening tools that will stratify
your risk for more definitive but unfortunately considerably more
expensive and risky invasive tests. You simply have to accept that.
Given the fact that the non invasive diagnostics are crappy, I would be
biased towards medical intervention at the smallest anomaly (bad lipids,
blood pressure etc.).


Consider popping a baby asprin if you are not already doing it and it
is not contraindicated for you based on any other medications you are
taking.

Roland


How echo test or holter test can support these conditions?

The latter can record evidence of inducible ischemia.
May GOD continue to heal your heart by curing your diabetes, dear
neighbor Kumar whom I love unconditionally.
Prayerfully in Christ's amazing love,
Andrew <><
--
Andrew B. Chung
Cardiologist, Atlanta, Georgia, USA
http://HeartMDPhD.com/HolySpirit
As for knowing who are the very elect, these you will know by the
unconditional love they have for everyone including their enemies
(Matthew 5:44-45, 1 Corinthians 13:3, James 2:14-17).
http://HeartMDPhD.com/Love
.

User: "Kumar"

Title: Re: both ct scan and thallium stress test? 26 Nov 2006 08:47:28 PM
Andrew B. Chung, MD/PhD wrote:

Kumar wrote:

Andrew B. Chung, MD/PhD wrote:

Kumar wrote:

Andrew B. Chung, MD/PhD wrote:

Kumar wrote:

Andrew B. Chung, MD/PhD wrote:

Kumar wrote:

snip> > > > > > Whether new arteries by angiogenesis always occur on
narrowing and

obstructtions of Cor. arteries?


New collateral arteries do not form when they are not needed.


When needed, say in case of narrowing or obstrucion of blood flow?


Correct.


How EECP can help in forming new collateral arteries or increase in
size? On the contrary it may discourage it?


It is possible that EECP may be helping to mobilize stem cells to form
these new vessels.


How?


There are stem cells residing in the arteries of the legs.

When blood supply is improved, why trigger to new vessels will be
needed?


The improvement in myocardial perfusion is transient and achieved by
raising pressures during diastole. The obstructions remain present
during EECP and so the need for collateral vessels will be apparent to
the possible relocalization of stem cells from the leg arteries to the
coronaries.

Will it also not happen without EECP?

Whether manipulating increase in blood flow by invasive or non-invasive
means discourage forming of collateral arteries and also decrease in
their size?


Collateral arteries are the non-invasive means of increasing blood
flow.


Yes, but Collateral arteries are formed due to decrease in blood flow?


They are formed where there is need, LORD willing.


What is stumuli to them?


The presence of the obstructive atheroclerotic coronary lesions


I think new Collateral arteries can be from upstream to downstream?


There is slowing of blood flow upstream of the obstructive lesion.

Can we also consider it as "decreased supply of nutrients/O2" ?


That would be downstream of where the collaterals will need to start
forming.


Will "decreased supply of nutrients/O2" be not due to upstream or/and
downstream reasons?


This will be downstream.

If there is a slowing of blood flow upstream of the obstructive
lesion, what can be the use of collaterals from downstream?

Some fats( saturated) are directly travell in circulation whereas other
via long process through lympatic system? Do such differences impact
our health in any way?


Not clinically seen.


Is it true that some saturated fats travel in circulation after
absorption directly whereas most other via lymph system route?


Clinical importance not established.


Can we consider such effects as effect of free fatty acids?


Lack of clinical importance is not an effect.


In what form, abosrbed fatty acids part in circulating or stored
triglycerides exists in body? Its chain and bond still remain same as
absorbed or processed and changed to different forms prior to their
oxidation and use for energy?


As lipoprotein particles.


Lipid profile also interpret triglygirides? Which type of chain is
there in fatty acid part of triglyceride present in blood or stored?


VLDL.

Can cholesterols in body be synthesized from fatty acids OR if they
need to be directly absorbed in intestines??

snip> > > > To compare, whch is more harmful out of saturated and
unsaturated fats

for either their storing capacity or free radicle/oxidative stress
causing capacity?


It is wiser to focus on ridding the VAT.


Just for understanding purpose.


For benefit.


Yes, but I meant which out of Saturated(esp. milk fat) and unsaturated
is more beneficial to diabetic2 without abnormal lipid profile? Few
thought that milkfat causes more bile secretion in intestine and more
of its excretion, so may cause usage and recirculation of cholesterols
and their control? Is it right?


It remains wise to focus on ridding the VAT.


Is it wise to take oils/foods with no cholesterol?


Not as wise as eating less.

snip> > Bit inconvenient/difficult but Can we eat more but still
optimal by

manipulating specific foods?


Not difficult for those who are using the 2PD-OMER Approach and have
overcome the brainwashing that "hunger is bad."

Can decreased blood flow to parts as a result to vasoconstriction or
decrease in size and numbers of arteries sypplying to tissues trigger
overeating?

snip> > > > > > What are bile abnormalities other than decreased flow
from liver or

gall bladder?


Still wiser to let your doctor(s) figure this out for you.


I don't have such abnormilty but want to understand, one reson why
ancient systems gave so much importance to bile?


This is what they could see with their eyes when they disembowelled
people.


That is measuring/understanding the imbalance. But what can be the
imbalances and disorders related to these?


None clinically seen.


How more or less secretion of bile and more or less of its
concentration can impact health?


The secretion of bile is not involved in the development and
persistence of type-2 diabetes.


It can effect fats absorption, more fats may be a reason to getting IR
?


More VAT from overeating is the reason for the IR.

What is the contribution of absorbed fats in forming VAT?

Whether amount, composition

and reabsorption of bile changes on

different exposures & abnormilities?


Still wiser to let your doctor(s) figure this out for you.


As above?


Yes.

Whether low gastric acid or excess bile is the reason to absorbing more
fats & IBS?


Not clinically seen.


What physiological effects, variations in atmospheric temperature &
moisture/humidity to which we are exposed can cause? Can high temp.
cause somewhat vasodilating and high humidity incread BP or
vasoconstricting effects, low temp. and low humidity opposite?


These effects are not clinically meaningful.


Can taking sauna or steam bath attract water from body benefitting to
those with cells swellings, edema etc?


Not clinically seen.


Can these effect oedma, cell's/intimal swellings?


Not clinically seen.


How sauna and steam bath differ on health impact?


Not clinically relevant.


Whether Prespitation from these,can benefit by removing water from
cells if abnormal due to hypotonic environment out of different cells?
Or, can such prespiration reverse hypotonicy?


Still not clinically relevant.

Can excessive prespiration express vasodilation whereas excess urine
vasoconstriction?

Prayerfully in Christ's amazing love,

Andrew <><
--
Andrew B. Chung
Cardiologist, Atlanta, Georgia, USA
http://HeartMDPhD.com/HolySpirit

As for knowing who are the very elect, these you will know by the
unconditional love they have for everyone including their enemies
(Matthew 5:44-45, 1 Corinthians 13:3, James 2:14-17).
http://HeartMDPhD.com/Love

.
User: "Andrew B. Chung, MD/PhD"

Title: Re: both ct scan and thallium stress test? 29 Nov 2006 06:12:54 AM
Kumar wrote:

Andrew B. Chung, MD/PhD wrote:

Kumar wrote:

Andrew B. Chung, MD/PhD wrote:

Kumar wrote:

Andrew B. Chung, MD/PhD wrote:

Kumar wrote:

Andrew B. Chung, MD/PhD wrote:

Kumar wrote:

snip> > > > > > Whether new arteries by angiogenesis always occur on
narrowing and

obstructtions of Cor. arteries?


New collateral arteries do not form when they are not needed.


When needed, say in case of narrowing or obstrucion of blood flow?


Correct.


How EECP can help in forming new collateral arteries or increase in
size? On the contrary it may discourage it?


It is possible that EECP may be helping to mobilize stem cells to form
these new vessels.


How?


There are stem cells residing in the arteries of the legs.

When blood supply is improved, why trigger to new vessels will be
needed?


The improvement in myocardial perfusion is transient and achieved by
raising pressures during diastole. The obstructions remain present
during EECP and so the need for collateral vessels will be apparent to
the possible relocalization of stem cells from the leg arteries to the
coronaries.

Will it also not happen without EECP?

Whether manipulating increase in blood flow by invasive or non-invasive
means discourage forming of collateral arteries and also decrease in
their size?


Collateral arteries are the non-invasive means of increasing blood
flow.


Yes, but Collateral arteries are formed due to decrease in blood flow?


They are formed where there is need, LORD willing.


What is stumuli to them?


The presence of the obstructive atheroclerotic coronary lesions


I think new Collateral arteries can be from upstream to downstream?


There is slowing of blood flow upstream of the obstructive lesion.

Can we also consider it as "decreased supply of nutrients/O2" ?


That would be downstream of where the collaterals will need to start
forming.


Will "decreased supply of nutrients/O2" be not due to upstream or/and
downstream reasons?


This will be downstream.

If there is a slowing of blood flow upstream of the obstructive
lesion, what can be the use of collaterals from downstream?

The collaterals will be coming from upstream to supply the deficit
downstream.

Some fats( saturated) are directly travell in circulation whereas other
via long process through lympatic system? Do such differences impact
our health in any way?


Not clinically seen.


Is it true that some saturated fats travel in circulation after
absorption directly whereas most other via lymph system route?


Clinical importance not established.


Can we consider such effects as effect of free fatty acids?


Lack of clinical importance is not an effect.


In what form, abosrbed fatty acids part in circulating or stored
triglycerides exists in body? Its chain and bond still remain same as
absorbed or processed and changed to different forms prior to their
oxidation and use for energy?


As lipoprotein particles.


Lipid profile also interpret triglygirides? Which type of chain is
there in fatty acid part of triglyceride present in blood or stored?


VLDL.

Can cholesterols in body be synthesized from fatty acids OR if they
need to be directly absorbed in intestines??

Cholesterols can be synthesized de novo from fats, carbohydrates, and
protein.

snip> > > > To compare, whch is more harmful out of saturated and
unsaturated fats

for either their storing capacity or free radicle/oxidative stress
causing capacity?


It is wiser to focus on ridding the VAT.


Just for understanding purpose.


For benefit.


Yes, but I meant which out of Saturated(esp. milk fat) and unsaturated
is more beneficial to diabetic2 without abnormal lipid profile? Few
thought that milkfat causes more bile secretion in intestine and more
of its excretion, so may cause usage and recirculation of cholesterols
and their control? Is it right?


It remains wise to focus on ridding the VAT.


Is it wise to take oils/foods with no cholesterol?


Not as wise as eating less.

snip> > Bit inconvenient/difficult but Can we eat more but still
optimal by

manipulating specific foods?


Not difficult for those who are using the 2PD-OMER Approach and have
overcome the brainwashing that "hunger is bad."

Can decreased blood flow to parts as a result to vasoconstriction or
decrease in size and numbers of arteries sypplying to tissues trigger
overeating?

Not clinically seen.

snip> > > > > > What are bile abnormalities other than decreased flow
from liver or

gall bladder?


Still wiser to let your doctor(s) figure this out for you.


I don't have such abnormilty but want to understand, one reson why
ancient systems gave so much importance to bile?


This is what they could see with their eyes when they disembowelled
people.


That is measuring/understanding the imbalance. But what can be the
imbalances and disorders related to these?


None clinically seen.


How more or less secretion of bile and more or less of its
concentration can impact health?


The secretion of bile is not involved in the development and
persistence of type-2 diabetes.


It can effect fats absorption, more fats may be a reason to getting IR
?


More VAT from overeating is the reason for the IR.

What is the contribution of absorbed fats in forming VAT?

When there is no overeating, there is no VAT being formed.

Whether amount, composition

and reabsorption of bile changes on

different exposures & abnormilities?


Still wiser to let your doctor(s) figure this out for you.


As above?


Yes.

Whether low gastric acid or excess bile is the reason to absorbing more
fats & IBS?


Not clinically seen.


What physiological effects, variations in atmospheric temperature &
moisture/humidity to which we are exposed can cause? Can high temp.
cause somewhat vasodilating and high humidity incread BP or
vasoconstricting effects, low temp. and low humidity opposite?


These effects are not clinically meaningful.


Can taking sauna or steam bath attract water from body benefitting to
those with cells swellings, edema etc?


Not clinically seen.


Can these effect oedma, cell's/intimal swellings?


Not clinically seen.


How sauna and steam bath differ on health impact?


Not clinically relevant.


Whether Prespitation from these,can benefit by removing water from
cells if abnormal due to hypotonic environment out of different cells?
Or, can such prespiration reverse hypotonicy?


Still not clinically relevant.

Can excessive prespiration express vasodilation whereas excess urine
vasoconstriction?

Not clinically seen.
May GOD conitnue to heal your heart by curing your diabetes, dear
neighbor Kumar whom I love unconditionally.
Prayerfully in Christ's amazing love,
Andrew <><
--
Andrew B. Chung
Cardiologist, Atlanta, Georgia, USA
http://HeartMDPhD.com/HolySpirit
As for knowing who are the very elect, these you will know by the
unconditional love they have for everyone including their enemies
(Matthew 5:44-45, 1 Corinthians 13:3, James 2:14-17).
http://HeartMDPhD.com/Love
.



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