Our Cardiologists Take Some of the ‘Stress’ Out of Stress Testing


We are proud of our clinical excellence in cardiac care. And we keep getting even better. Our MAPMG cardiology team recently won a national award for a new “Stress First” protocol they developed to improve how to minimize the use of nuclear stress tests for cardiac patients. This results in improved quality and speed of care for our patients, is safer for our providers, and contributes to our affordability mission.

Nuclear stress tests are used to measure blood flow and motion of the heart in patients who are at risk for heart disease. These tests have two portions – a stress test and a rest test – and  use a small amount of a radioactive chemical compound known as a radiotracer. If used frequently, these radiotracers can carry a small, but significant risk of cancer.

Permanente Cardiologists Sudip Saha, MDJoseph Lodato, MD, and Managing Director of Special Projects, Nancy Ortiz, wanted to improve protocols for imaging that would reduce radiation exposure for patients. They developed a protocol in which they split the test into its two portions.   They perform the “stress” test first and read the results. The cardiologist will order the second “rest” portion of the test only when the results show abnormalities of ambiguities of the heart.

Kaiser Permanente implemented this new protocol in October 2018. It resulted in a 76% radiation dose reduction for those who only needed the stress-only test. Additionally, with patients undergoing fewer tests, physicians have time to care for more patients. We prevent some of the risks of unnecessary testing and ensure we are always administering the right test for the right patient.

Our cardiac care specialists are always raising the bar in the Mid-Atlantic region and beyond, making Kaiser Permanente the region’s leading health system. If you are interested in learning more about the development of the “stress first” protocol for this national award, read some of Dr. Saha’s thoughts here.

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