need advice please

[RRMLPN]

Hello, I have a question.. went to er the other night, have been having chest pain on and off about 2 weeks no N/V ,no diaphoriesis, completely atypical. But had strained my left arm a couple weeks ago also while lifting an ac out of the window( i know stupid move but it had to come out of there) anyway, i had 2 good ekg's, all my lab were normal both times . they were all taken about 8 hours apart, i do have a family hx of CAD. So the doc wants to transfer me out to a cardiac specialist to have a heart catherization done.

ok, i speak with the cardiologist on the phone, I ask for a stress test first and perhaps a echo just to see.. he says no you'll have to have a cath done anyway, now this doc has never seen me yet, knows all my tests were normal, knows i have had no recurrence of chest pain, but still have some muscle pain related to lifting. I signed myself out AMA... and will go tomorrow to see my regular doc. Was just curious if this is the norm when dealing with cardiac specialists. Thanks .

[Noney]

Have your Dr send you to another cardiolagist outpatient!

Noney

[renerian, BSN, RN]

I would see someone else. I think it is silly to jump to the cath first.

Lets see what some cardiac nurses think. renerian

[RNKPCE]

With all your test negative so far. I would think most cardiologists would do a stress treadmill test first.

[RRMLPN]

Thanks for your replies, went to another doc i know and have worked with and have a stress test scheduled for the 21st. Then we will see how that goes . I was very uncomfortable with the first scenario and went with my gut feeling, glad i did. thanks again :)

[live4today, RN]

Gotta watch those money hungry Cardio specialists who thrive on doing boo-koo cardiac cath procedures. Good for you for going for another opinion and taking charge of your own healthcare.

[Dave ARNP]

Okay...

Let me give you a little story/advice here.

I, myself I had a cardiac episode and after treatment in ER was discharged and referred to the cardiologist that I asked the NP in ER to refer me to. However, supervising MD in ER demanded that on the referral to the cardiac doc, I be scheduled to an EPP.

I went to the doc, knowing he had better sense than to jump into this procedure and was scheduled for Stress/Holter/Echo which I am complete on Monday... PRIOR to jumping into the Electo-physio profile.

What did my Cardiologist say when he say the referral that demanded the EPP?

"You have to go to highschool before college"

I'd get some better advice. Jumping into a cath is certainly acceptable... HOWEVER... It's usually only done by rolling you from ER on out to the Cath Lab.

We don't send a lot of pts. to cardiac docs on the initial visit... for a cath...

Actually... I NEVER have. Don't know anyone who has.

David Adams, ARNP

-ACNP/FNP

[RRMLPN]

Thanks David. I appreciate you sharing that with me and makes me feel even more so that i made the right decsion.