meta_pixel
Tapesearch Logo
Log in
Emergency Medicine Cases

JJ 15 Cardiac Stress Testing After Negative ED Workup for MI

Emergency Medicine Cases

Dr. Anton Helman

Education, Health & Fitness, Courses, Medicine, Science

4.7602 Ratings

🗓️ 9 April 2019

⏱️ 56 minutes

🧾️ Download transcript

Summary

In this Journal Jam podcast we do a deep dive into the hugely complex literature of cardiac stress testing and see whether or not stress testing portends any benefit for patients who we assess in the ED for chest pain. The problem is - if stress testing doesn’t benefit our patients and isn’t a good screening test for preventing MIs, then what do we do with our low risk chest pain patients we see in the ED?

Transcript

Click on a timestamp to play from that location

0:00.0

About 10 years ago, my father, Arthur Helm, and a primary care doctor, offered to take me and my

0:04.0

brother to Patagonia on a week-long hiking trip. For me, it was a no-brainer. Of course, I said,

0:10.3

thank you so much. Now, my father was never the active type, and his father, my grandfather,

0:16.1

died at the age of 69 of a massive MI, the same age as my father was at the time he wanted to go on this trip.

0:23.1

And so I asked him, do you think you're in good enough shape to climb a mountain?

0:27.9

Well, he said, I'm going to go get a treadmill stress test, and if it's negative, I'll be good to go.

0:34.5

So I said, really? Have you been having any chest pain or shortness of breath or any cardiac

0:39.0

symptoms at all? Because you know as well as I do that there's a huge false positive rate for stress

0:44.6

tests and you might end up having to go for an angiogram and maybe a stent or a cabbage,

0:50.0

which are majorly invasive with potential complications and disasters, etc.

0:54.0

You know, I told them it would be crazy to go for a stress test, especially since you're which are majorly invasive with potential complications and disasters, etc.

0:56.7

You know, I told him it would be crazy to go for a stress test,

1:00.0

especially since he's not having any symptoms whatsoever.

1:03.1

And all he said was, think what you want.

1:04.9

I'm going to get a stress test.

1:08.1

So off he went to get his treadmill stress test,

1:10.6

and you guessed it, it was positive. So he decided the next day to go get a treadmill stress test, and you guessed it, it was positive. So he decided the next day to go

1:13.1

get a nuclear stress test, and it was positive too. So then he called me up to tell me the bad news

1:19.5

and begged me to contact one of my cardiology buddies to get an angiogram. It was, I remember,

1:24.8

a Friday afternoon, and of course, I obliged.

1:28.3

So on the following Monday, he got an angiogram.

1:31.2

What did it show?

...

Please login to see the full transcript.

Disclaimer: The podcast and artwork embedded on this page are from Dr. Anton Helman, and are the property of its owner and not affiliated with or endorsed by Tapesearch.

Generated transcripts are the property of Dr. Anton Helman and are distributed freely under the Fair Use doctrine. Transcripts generated by Tapesearch are not guaranteed to be accurate.

Copyright © Tapesearch 2026.