What's the Most Accurate Heart Disease Test?

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The sensitivity of all those tests are fairly similar. I prefer a test where a patient does exercise because it shows us what the real world is. And in general, the nuclear stress test is slightly more sensitive than an echo stress test. But, that being said, there's no radiation with an echo stress test.

So if I have a 50 year old woman, and I don't want to expose her to radiation in the chest, I'll do a stress echo first. If I see something abnormal, it might lead me to more testing. The difference between a stress echo and a nuclear stress test, is that a stress echo shows us abnormality if the heart muscle is not contracting as well as it should.

Whereas a nuclear stress test looks at the blood flow or profusion to the artery. So it's a little bit earlier in the process. So, it sees something maybe a little earlier than a stress echo does, but the stress echo will definitely pick up a wall motion abnormality.