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June 2014

Just One More “Noninvasive” Test…

Author Affiliations
  • 1Retired attorney in California
JAMA Intern Med. 2014;174(6):855. doi:10.1001/jamainternmed.2014.850

Twenty years ago I made the decision that I wanted to avoid unnecessary radiation in medical procedures. Recently, when I was scheduled to have cataract surgery, I followed my physician’s preoperation orders to have an electrocardiogram (ECG). Who would have thought this test would leave me, 5 days after successful eye surgery, with having to decide whether or not to follow a cardiologist’s order for yet another test—this one involving a significant amount of radiation?

Nine days before the cataract surgery, my primary care physician (PCP) telephoned me. “The ECG report says there’s evidence you may have had a heart attack in the past,” she said. “I’d like you to have a stress test before surgery.” I was stunned by this news. I am a healthy 71-year-old woman who recently celebrated 40 years of regular vigorous lap swimming 2 to 3 times a week. I have been leading a hike nearly every month for the public in the local Coast Range Mountains for over 25 years. I sweat in an aerobic dance class at the Y weekly and take frequent long walks. To top it off, I have never had any chest pain or other symptoms of heart disease.