So should you have an EBT?
As with every medical decision, it depends.The easiest answer would be to simply endorse the expert consensus of the AHA and ACC (which which, in fact, DrRich agrees), and say no, don’t get one until better data is available. But that would leave you watching all those commercials featuring Henry, and wondering, after all, wouldn’t it be ok to get yourself checked?
And while we’re all waiting for more data, heart disease is still the number one killer in the U.S., and while many victims have plenty of warning and plenty of opportunity for early medical intervention, the fact remains that for a substantial minority of individuals (several hundred thousand a year), sudden death is the very first sign that anything is wrong. So it is very reasonable for Americans to wonder about the state of their coronary arteries, even if they’re feeling entirely well.
It is surely logical to consider having a test, one you can schedule and pay for yourself, that is very good at detecting the presence of coronary artery disease – even if that test can’t tell you the severity of the disease.
It’s just that, if you decide to have the EBT, you had better understand its drawbacks as well as its advantages. Its major advantages are that, if the test is negative, the probability that you have significant coronary artery disease is very small; and that if you do have significant coronary artery disease, the EBT will very likely be positive. Its major disadvantage is that even if you do not have significant coronary disease, the test is also reasonably likely to be positive. And that means you may receive a heart catheterization you don’t really need. Whether that is a minor inconvenience or a very bad thing depends almost entirely on your feelings as an individual. (I’m not taking insurance companies into account here. They would, I suspect, always consider it a very bad thing to have to pay for catheterizations that were not necessary.)
If used appropriately, in individuals who are motivated to know with a high degree of certainty the state of their coronary arteries, and who are willing to pay the price of a potentially unnecessary catheterization to get that information, the EBT can be very useful and very gratifying.
So the EBT may be for you, but don’t decide by listening to cheesy commercials or to panicked naysayers. Decide by considering: with how much certainty do you need to know about your coronary arteries? If you have a lot of risk factors, you would be quite justified in wanting to pursue the answer vigorously. On the other hand, if you are a young person with few risk factors, in whom a “positive” test is particularly likely to be a “false positive,” the EBT would make far less sense. Either way, since many doctors are still not being very objective on this matter, it would be to your benefit to keep yourself on an even keel, to consider all the available information objectively and dispassionately, and to make your own decision.
