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Forum Name: Ischemic Heart Disease

Question: Opinion about Job clearance scenario!!!


 tsr92571 - Tue Feb 12, 2008 9:55 pm

I am 36 Y/O male 6'1 260lbs. firefighter. I was recently flagged on a yearly physical regarding EKG results after stress test on stationary bike.

I was shown greater than 3mm ST Depression in lead V3 with T wave inversion. When I was 21-23? I have had these same results, and I was tested by stress test, holter monitor, blood work, etc. I was told I had a healthy heart by cardiologist and electro physiologist.

I was referred to a new cardiologist from this physical, because my previous cardiologist has retired, and I haven't seen him in 15 years.

I had an Echo which I was told was normal and Nuclear stress test done.The stress test showed this depression throughout the test, and I have been asysmptomatic the whole time.I was told I had normal blood flow, no known blockages, but my efficiency was slightly decreased and I have the abnormal EKG.

I can't return to work without my physician signing a clearance letter. He stated, " If I had a regular like office job it would be no problem to return to work, but he wants to do a cardiac cath to ultimately rule out anything."

I don't really want to do the cath because I'm asymptomatic and its invasiveness.
My question is: Would it be wrong to seek a second opinion? Is there any other less invasive procedures to help with ruling out for ultimate assurance?

Thanks,

tsr92571
 Dr. Chan Lowe - Wed Feb 20, 2008 1:19 am

User avatar Hello Tsr92571,

It is always reasonable to seek a second opinion. Many people feel this means they don't trust their doctor or their doctor will be offended. Most physicians are not at all offended by a second opinion. In fact, many welcome the chance to have another doctor look over everything to see if there are any other ideas.

It sounds like you've had quite an extensive work up so I can't come up with an alternative to a cardiac catheterization other than possibly a cardiac MRI (which may not be available in all places). I understand your doctor's concern as well as yours so I think obtaining a second opinion is very reasonable.

Best wishes.

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