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Dr G N Mahapatra, head of department of non-invasive cardiology at Seven Hills Hospital, Mumbai explains how nuclear medicine can help avoid unnecessary angioplasty and why many cardiologists don’t prescribe it.
Dr Mahapatra says: “Several patients who undergo angioplasty return with the symptoms. That’s because the patient did not need an angioplasty. After the first heart attack, certain heart muscles die and cannot be recovered. But cosmetic angioplasties are still carried out throughout India.”
According to Dr Mahapatra, “Angiography can only detect blockages, and often gives false positives in female patients. Nuclear medicine can also show if the heart muscle is already dead and helps avoid unnecessary surgeries. The tests are also painless and non-invasive, and it costs about a third of an angiogram.”
Nuclear medicine relies on radioactive isotopes to assess the blood flow in the heart. A technician inserts radioactive isotopes such as thallium intravenously. The isotope marks the blood flow and a gamma camera maps it. The test includes readings in active and resting positions.
“Besides thallium, we now also use technetium, the lightest element of radioactive isotopes. It does not leave behind any radiation and is excreted from the body in six hours. In Europe and USA, most cardiologists compliment their practice with nuclear medicine,” says Dr Mahapatra.
“Cardiologists must offer a conclusive test such as the thallium test before going ahead with surgery. Unfortunately, some cardiologists say creating more awareness about this would affect business,” adds Dr Mahapatra.
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