instruction: hello doctor I was diagnosed with a left branch bundle block a few years back I have been under the care of a cardiologist to make sure my heart is fine since then I have done stress echo yearly or every two years since and have been told my heart is otherwise fine I just had to switch the other doctor because of insurance and my new doctor says old stress echo are irrelevant that only chemical or nuclear echo work in patients with lbb is this true I have a strong family history of heart disease my father survived two heart attacks mother survived double bypass and my maternal uncle died from a heart attack all were smokers with high cholesterol and high blood pressure I am a former smoker I am a 43 year old female I have been exercising six days per week for over 20 years my cholesterol is high 213 but hel is 140 and triglycerides are low I am a little put off by a nuclear stress echo and would prefer the regular exercise but I want to know what this new doctor says is true then I guess I will have to go nuclear I am currently taking spironolactone 100 my for acne omeprazole and multivitamin I just had an ultrasound of heart and ekg past monday doctor did not mention anything other than lbb that was previously diagnosed
output: hello welcome to icliniq com treadmill test is not very informative in case of lbb patient however stress echo either exercise or nuclear is valid stress thallium is the best test to be done in you I guess you did not have any symptoms like chest pain or heaviness during stress test and if so it will still suggest the absence of significant heart disease in my opinion there is not much difference between exercise echo and chemical stress echo and not invalid but nuclear scans like stress thallium is certainly a better test I would advise for a nuclear scan as it would be more informative anyhow you should have a healthy lifestyle like avoiding fatty oily and high calorie diet have a low salt diet and monitor your blood pressure regularly do regular exercises like brisk walking jogging according to your capacity at least 30 minutes a day and days a week eat lots of green leafy vegetables fruits and fish once or twice a week avoid meat smoking and alcohol if any there should not be any abdominal fat deposition or obesity get your lipid profile and sugars tested once