Medical Tests & Procedures Archive

Q. Why is my doctor checking me for tuberculosis? I thought that was eradicated long ago

A. It would be wonderful if tuberculosis (TB) had been eradicated long ago, but unfortunately that's not the case. It is true that the annual number of new cases in the United States has been dropping over the past 20 years; in 2013, there were about 9,500 new cases. However, around the world, particularly in developing nations, TB remains a huge problem. In 2013, there were nine million new cases of TB, and 1.5 million deaths from TB, in the world.

By Anne Fabiny, M.D., Editor in Chief

President Barack Obama recently announced the Precision Medicine Initiative, a new program to speed up discoveries based on information and technology stemming from the Human Genome Project. "Precision medicine" and "personalized medicine" are terms that describe health care tailored to an individual patient's genetic makeup, using information about a patient's genome to diagnose illness and design therapies to treat and cure disease. This approach has been described as "the medicine of the future."

However, it may be reassuring to know that although your doctor doesn't have your genome at hand, he or she is likely to be giving you personalized care as we understand it today.

Q. The other night I woke up at about 2 a.m., and my heart was pumping hard and my lower jaw ached. It lasted about an hour, even though I took aspirin. Then I fell asleep. In the morning everything was fine. Was that a heart attack?

A. If you were my patient and you called my office and told me this, I would tell you to come right in and let me check you out. Probably it was not a heart attack, but the chance that it might have been is high enough that you need to be examined and tested. I hope that's what you did. If you didn't then, you should check with your doctor now.

Hidden causes of shortness of breath can make the problem tricky to treat.

When your heart muscle doesn't get enough blood, chest pain is possible. But you might not feel anything at all.

Small, wireless skin patches may offer a convenient way to diagnose—or rule out—arrhythmias.

An abnormal heart rhythm—when your heartbeat is too slow, too fast, or irregular—may be a fleeting, harmless event. But it might be a sign of a more serious heart condition. If you have frequent palpitations (which feel like your heart is pounding, racing, or fluttering) or unexplained fainting spells, your doctor may recommend a Holter monitor. This portable electrocardiogram (ECG) machine records your heart rhythm over a day or two.

Q. I have a pacemaker and was told to never have an MRI scan. Is there any way around that?

A. In the past, people with pacemakers were told never to have magnetic resonance imaging (MRI), but in certain cases it may be safe.

Experts still advise getting regular blood lipid tests.

In late 2013, when the new national guidelines on managing cholesterol were released, many people wondered how the change would affect blood cholesterol testing. Also known as a lipid profile or lipid panel, the cholesterol test measures several different types of fats (lipids) in your bloodstream.

A portable ultrasound device that detects plaque buildup in arteries may offer a simple, cost-effective way to detect heart disease before it causes any symptoms. A report in the December 2014 Global Heart journal describes findings from a large-scale test of the technology in India, the United States, and Canada.

The innermost layer of an artery's wall (the intima) provides a smooth surface for blood to flow through. The middle layer (the media) contains muscle and elastic fibers that let the vessel expand and contract with each heartbeat. The thicker the intima and the media, the more likely the artery is choked with cholesterol-filled plaque. Using ultrasound, a doctor can easily measure the intima-media thickness in the arteries of the neck and upper leg.

Q. My doctor has recommended a bone density screening, but the medical center with the full-body scanner is a 45-minute drive from my house. A health fair at a neighborhood church offers a bone density test using a foot scanner. Would that be as accurate?

A. The foot scan is called a quantitative ultrasound, and it usually measures the bone density of the heel bone.
It appears to be at least as good as clinical risk factors—such as older age, family history of bone fractures, low body mass index, smoking, corticosteroid use, and excessive alcohol consumption—for identifying people at high risk for osteoporosis.