Medical Tests & Procedures Archive

Ask the doctor

Q. My cardiologist mentioned that he was going to do a "bubble study" during my echocardiogram. What is that?

A. During an echocardiogram, a technician uses a probe that emits high-frequency sound waves (ultrasound) that "echo" off the structures of your heart. The waves, which are translated into video images visible on a monitor, can reveal in-formation about your heart's structure and function. A bubble study gives added information, as it can identify potential blood flow issues inside your heart.

Research we're watching

Popping an aspirin before taking a common test designed to detect blood in the stool, a sign of colon cancer, doesn't improve test accuracy, according to a study published May 7 in JAMA. Some observational studies had found that taking an aspirin before the test improved its sensitivity. Study authors speculated that this could be the case because aspirin's blood-thinning effects made it more likely that blood from abnormalities in the colon would make its way into the stool, where it could be detected.

But this trial, which included 1,200 adults, didn't find the same link. Researchers divided participants into two groups: one that took aspirin before the test, and another that did not.

In the journals

Even if you believe you're in excellent health, you could still be at risk for a heart attack or stroke, suggests a study of more than 6,800 people, average age 62, published Feb. 15, 2019, in JAMA Network Open. At the study's beginning, participants rated their health as excellent, very good, good, or poor/fair. (More than half the men reported being in very good or excellent health.)

Next, everyone had a coronary artery calcium (CAC) scan, which detects plaque buildup in the arteries of the heart. The scores range from zero to 100 and higher, with zero meaning no plaque buildup is present and cardio-vascular disease risk is at its lowest.

This noninvasive test can predict plaque in the heart's arteries. But it is useful only in certain situations.

Imagine a 57-year-old man (let's call him Bill) who's in pretty good health — a nonsmoker who eats right and exercises regularly. He takes two drugs to treat high blood pressure. Even though his LDL (bad) cholesterol isn't all that high, his primary care doctor suggests that Bill consider taking a statin to lower his risk of a heart attack.

Bill is a little hesitant to add another drug to his daily regimen, so his doctor tells him about a test that may help with the decision: a coronary artery calcium scan. This noninvasive test, which can reveal dangerous plaque in the heart's arteries, has been available for more than a decade. But calcium scans (as they're often called) are now recognized in official guidelines and are being used far more often than in the past, says Dr. Ron Blankstein, a cardiovascular imaging specialist and preventive cardiologist at Harvard-affiliated Brigham and Women's Hospital.

New research aims to capture and eventually cure incessant ringing in the ears.

More than 50 million Americans struggle with tinnitus, a constant or recurring ringing in the ears that ranges from irritating to debilitating. Some treatments work for some people, but none seems to work for everyone.

Tinnitus is a tough condition for doctors to study. "There's no way to measure it directly. The only way we know you have tinnitus is if you tell us. Even if there were a cure, we wouldn't know how it worked because we have to rely on verbal descriptions of what your tinnitus sounds like and how loud it is," says Daniel Polley, director of the Lauer Tinnitus Research Center at Harvard-affiliated Massachusetts Eye and Ear.

Recent research reignited interest in inflammation, a major player in heart disease.

A buildup of cholesterol-rich plaque inside arteries — known as atherosclerosis — is the root cause of most heart attacks and strokes. Researchers have long recognized that chronic inflammation sparks this artery-damaging process (see "Understanding inflammation"). Now, they're zeroing in on better ways to tackle that aspect of the problem.

Addressing inflammation is vital. Even when people take steps to lower their risks for heart disease, such as reducing their cholesterol and blood pressure, they may still face life-threatening cardiovascular events.

The FDA may require mammography facilities to notify patients about this breast cancer risk factor, but women don't know what to do with this information.

Do you know how dense your breasts are? If you don't, a new proposal by the FDA may mean you will soon find out.

The agency proposed a change that, if approved, will require mammography facilities to send letters informing women about their breast density — a measure of the proportion of active tissue versus fat in their breasts (see "The FDA proposal").

A new study supports the use of noninvasive brain stimulation in people with severe depression who haven't responded to medication.

If medication isn't helping to ease severe depression, nonsurgical brain stimulation may be an effective alternative to consider, according to a study published online March 27 by The BMJ. Specifically, the study found that evidence seems to back the use of repetitive transcranial magnetic stimulation (rTMS) and electroconvulsive therapy (ECT) over other, newer brain stimulation therapies.

"Many psychiatrists are unaware of these techniques, or at least don't think to recommend them for their patients," says Dr. Daniel Press, associate professor of neurology at Harvard Medical School and the clinical director for the Berenson-Allen Center for Noninvasive Brain Stimulation at Beth Israel Deaconess Medical Center. "So, studies like this are helpful in raising the banner and reminding people that these are very effective options for a large percentage of people."

Q. I have always had my blood tests taken the first thing in the morning, before I've had breakfast. We've just moved to a new home and I'll have a long commute to the hospital, so I'd like to eat before I start out. My cholesterol has always been great, so my doctor said a light breakfast won't interfere with cholesterol tests. But he didn't know if eating would change my PSA result. What do you think?

A. At last — a PSA question with a simple, un-equivocal answer: Breakfast will not affect your PSA result, nor will lunch or dinner. In June 2005, doctors proved the point by measuring PSA levels three times over the course of a single day in 80 patients with an average age of 62 years. The samples were obtained before breakfast, after breakfast, and after lunch — and there were no changes in the PSA results.