Getting a cath or stress test done - just in case

[CPR]

I have no known medical issues but my family has extensive heart issues. I have thought about getting a cath or stress test done just to make sure I don't have something major hiding to get me down the road.

Current part 135 pilot - 2nd class medical


Thoughts on this?

 

[TCABM]

Health first. But, an open and honest conversation about family history and your risk factors with your PCM would be a good place to start. Lab work can help to further inform that conversation. Then, an informed decision can be made whether to do further diagnostics.

I recently did the Bruce with echo stress test, at the FAAs request due to a very distant history of a heart problem. While it wasn’t particularly difficult to meet the requirements for duration, you will want to practice it a couple of times before you do it.

 

[Chaperral]

Lose weight to ideal, not average weight;get an hour of exercise daily, Mediterranean diet, cut out red meat, get cholesterol under 150, get blood pressure under 120. This advise is good regardless of any test you do provided you have no symptoms. This advice is good even if your tests you are having done turn out perfect.

 

[dtuuri]

I have no known medical issues but my family has extensive heart issues. I have thought about getting a cath or stress test done just to make sure I don't have something major hiding to get me down the road.

Current part 135 pilot - 2nd class medical


Thoughts on this?

Do you know the cost of a heart cath? If there is no medical necessity it surely would all come out of your pocket. One of those isn't risk free, either. You could cause more trouble than going without. Why don't you simply assume you have about the same genes as your family tree and control the two things you can, diet and exercise? I'm sure a stress test and blood tests are reasonable enough to request, but even if they're "normal" (or even optimal) I wouldn't keep on keeping on, based on my personal experience. I'd consider a low fat, but high omega 3 to omega six ratio diet. I'd check my blood sugar every day, too. In fact, that's what I'm doing. My cardiologist says I'm doing everything right to minimize the risk of "events" which are driven by the genes in my family tree.

 

[Let'sgoflying!]

After a pal had a major cardiac event (much younger than me) I was told by a cardiologist not to bother with the stress test and certainly not an invasive test like the cardiac catheter/imaging.
Now, he was in a university setting - and did not benefit financial gain from a multitude of tests.
He said much the same as Chapperal above; diet, exercise, I think a glass of red wine a day, BP and cholesterol/lipid control, choose good genetics lol.

 

[Stewartb]

If you're in decent health and condition a Bruce protocol stress test is no big deal. Whether to do one or not should be your physician's call.

 

[brcase]

Primary Care providers and FAA Medicine are two disconnected entities with different priorities which are often different than your priorities.

A friend of my recently had his provider recommend a procedure for which the only reason he can find that makes any sense as to why it was recommended is that his provider has done more of these procedures than any other doctor. Of course the procedure would delay the reinstatement of his medical certificate even further than it already is.

PCP don't know which medications and procedures are Taboo by the FAA and as a result can not make educated recommendations on what is best for you overall. Unfortunately the current system is that You are responsible to know what is best for you, and assuming your PCP knows may mean you have to deal with consequences later. Childhood ADHD prescriptions are a perfect example of unintended consequences with the FAA.

As for the OP's question of course get your PCP opinion, but before proceeding with procedures run it by a senior AME such as Dr Bruce. I would be afraid if you have a Cath or other tests done the FAA's view will be that you had something happen that makes you think you have an issue, so now you may be required to do additional tests and provide documentation to prove you don't have an issue, And of course wait the many months for them to review it.

Brian

 

[James331]

You’re a 135 pilot and you’re asking this question lol

 

[Morgan3820]

Lose weight to ideal, not average weight;get an hour of exercise daily, Mediterranean diet, cut out red meat, get cholesterol under 150, get blood pressure under 120. This advise is good regardless of any test you do provided you have no symptoms. This advice is good even if your tests you are having done turn out perfect.

Cut out red meat? Bacon is pork which is white meat so I’m good. Life without bacon is not living.

 

[Chaperral]

Cut out red meat? Bacon is pork which is white meat so I’m good. Life without bacon is not living.

Well, I guess if you're skinny, getting plenty of exercise, low cholesterol and blood pressure, then try the Dr Atkins diet.

 

[Morgan3820]

Well, I guess if you're skinny, getting plenty of exercise, low cholesterol and blood pressure, then try the Dr Atkins diet.

Not skinny so, alternatively, was thinking enjoy BBQ, Beer, good whiskey, flying under basic med, then stroking out early eighties and skip the assisted living home.

 

[Kenny Phillips]

Lose weight to ideal, not average weight;get an hour of exercise daily, Mediterranean diet, cut out red meat, get cholesterol under 150, get blood pressure under 120. This advise is good regardless of any test you do provided you have no symptoms. This advice is good even if your tests you are having done turn out perfect.

So easy to state it, so difficult to do it.

 

[bbchien]

I would never do something invasive without a good reason.
If you are an “I gotta have a test to make me do what I SHOULD do”...person, then get a stress treadmill, which will at least mean something.

but it really does boil down to
Don’t get fat, keep your BMI 25 or less....
Don’t get sedentary...get exercise
Control cholesterol
And eat right.....or it wasn’t good food to grandma"....likely it’s really”not food”.....

 

[Rushie]

I would never do something invasive without a good reason.
If you are an “I gotta have a test to make me do what I SHOULD do”...person, then get a stress treadmill, which will at least mean something.

but it really does boil down to
Don’t get fat, keep your BMI 25 or less....
Don’t get sedentary...get exercise
Control cholesterol
And eat right.....or it wasn’t good food to grandma"....likely it’s really”not food”.....

This^^^^^

 

[PaulS]

Also consider these tests, including a stress test can have false positives, sending you down a road of more needless procedures. Best to discuss with your GP whether you need a test or not.

 

[bobmrg]

Don't do it. You must explain any and all doctor/hospital visits to the FAA, and they are paranoid.

 

[DFH65]

Long story but take it from a guy who really didn't need a stress test in the first place but took one because a doctor said family history blah blah blah then had a false positive on a nuclear stress test (for other reasons a regular stress test would not be conclusive for me) freaked out for a couple days thinking I was dying, went to the cardiologist who said "I think it is a false positive but let's do a cath anyway otherwise every time you are having sex with your wife (she was in the room) and feel a muscle twinge you are going to wonder if you are about to die". Had the cath the next day and thankfully it was clear.

Stay away unless you need it. I can take you down a path that is costly and quite possibly unnecessary as it was in my case and will make your medical complicated to say the least. A cath is certainly not without risk. I think the risk of mortality is like .1% for diagnostic tests and over 1% for interventions.

 

[azure]

Long story but take it from a guy who really didn't need a stress test in the first place but took one because a doctor said family history blah blah blah then had a false positive on a nuclear stress test (for other reasons a regular stress test would not be conclusive for me) freaked out for a couple days thinking I was dying, went to the cardiologist who said "I think it is a false positive but let's do a cath anyway otherwise every time you are having sex with your wife (she was in the room) and feel a muscle twinge you are going to wonder if you are about to die". Had the cath the next day and thankfully it was clear.

Stay away unless you need it. I can take you down a path that is costly and quite possibly unnecessary as it was in my case and will make your medical complicated to say the least. A cath is certainly not without risk. I think the risk of mortality is like .1% for diagnostic tests and over 1% for interventions.

^^^^ This.

A long time ago after an episode of chest pain, I had a nuclear stress test that came back "equivocal". Since false positives on these tests are common in women (due to absorption of the radiation in breast tissue, subcutaneous fat, etc.), we did not do a cath, but rather I was referred to a cardiologist who specializes in stress echos. The stress echo was definitively negative, and since I went into Stage 5 on the Bruce protocol, it was apparently an easy call for OKC to accept this result on my next medical.

But it was definitely a very nerve-wracking experience and I was glad to put it behind me.

As others have said, you always have to consider the possibility of false positives when doing any kind of diagnostic test. This is less likely with a cath, but then there is the risk of complications from any invasive procedure. And if you are found to have significant blockage in a coronary artery, even if you are asymptomatic and medically only conservative treatment is recommended, you might find yourself grounded unnecessarily.

 

[Rick Allan Scott]

Keep in mind that when you re-apply for your medical, you will have to list the reason for your visit to the cardiologist and the FAA will likely want the results of the test. You will likely get a letter a month or so after your medical from your AME. If you omit this test and you have a problem later, the FAA will likely get wind of your stress test through the doctor’s narrative that they require to either get a medical back or for re-issue. Bottom line: Either be 100% honest and report or ignore it and hope for the best.