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anteroapical perfusion defect
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krer posted:
Can anyone tell me what an anteroapical perfusion defect is? My mom had a stress test done and the nurse told her that but she doesn't have an appointment until February 19 to talk to the dr. She is very worried about this so any info would be appreciated. Thanks so much, erika
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James_Beckerman_MD responded:
A nuclear stress test provides information regarding the coronary artery blood flow to the heart muscle. A "perfusion defect" is a way of saying that there is the appearance of reduced blood flow to a part of the heart muscle. "Anteroapical" refers to the front tip of the heart. A perfusion defect can mean there is a blockage in an artery, there has been a heart attack previously, or sometimes the defect is just a function of the test not being perfect and the images are just not well seen. If your mom doesn' t have an appointment for another three or four weeks, I recommend you call her doctor to get the results before then. Take care.
 
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CardiostarUSA1 responded:
Hi Erika: Very worried no doubt. b Be well-informed TWO MAIN concerns regarding a nuclear stress test involves an actual narrowing or scarring, i.e., the findings of reversible (ischemia) or non-reversible (fixed, permanent, scar tissue) perfusion (blood flow) defects. When images return to normal at rest, this indicates there is no permanent injury to the heart muscle. Reversible perfusion defect is an area of the heart muscle that does not receive an adequate amount of blood at stress (ischemia) but does so at rest (reversible ischemia) which is caused by one or more narrowed or restenotic (renarrowed) coronary arteries or bypass grafts. Unless it's a false-positive result, a fixed perfusion defect indicates a heart attack (myocardial infarction) has occurred. After stress myocardial perfusion imaging (stress MPI, e.g., gated-SPECT scan with Cardiolite or Myoview), one's cardiologist may take some time to study the results of the scan before discussing the findings. One can typically expect one of the following four results - i 1: b No perfusion defect after exercise or at rest The heart muscle and blood flow to the heart muscle appear to be normal. i 2: b Perfusion defect after exercise, BUT NOT at rest (reversible defect) There is some degree of blockage in a coronary artery that interferes with the blood flow to the heart muscle. In someone with significant heart disease, when the heart works hard, it does not get the blood supply and oxygen that it needs (a supply and demand mismatch). At rest, however, the blood adequately reaches these areas or regions, e.g., ANTERIOR/ANTERO (front wall), POSTERIOR (back wall), INFERIOR (lower area/lower wall area), APICAL/APEX (bottom tip of the heart) and LATERAL (side wall). The heart muscle has living cells/tissue in these areas. This indicates that clearing the blockage in the affected artery will be of benefit. i 3: b Perfusion defect AFTER exercise AND at rest (fixed defect) There is one or more totally blocked coronary arteries and one has had damage done to the heart muscle because of a heart attack. There is an area (or areas) of the heart muscle that has become scar tissue (scarring, scarred) because of the MI. This area would not be able to make functional use of any oxygen even if blood flow to that area of the heart were completely restored. i 4: b Combined reversible and fixed defects It is common for individuals with coronary artery disease (CAD) to have different degrees of blockages in different arteries. A heart attack has left a fixed defect in one area of the heart, but there is a reversible defect in another area of the heart due to a less severe blockage. - Most important, communicate well with her doctors at ALL times. Best of luck to your mom. Take care CardioStar* WebMD community member (8/99) - - i Additional info A nuclear stress test does not image the coronary arteries, does not indicate what is going on in the arterial wall, it shows myocardial perfusion (blood flow to the heart muscle, or lack of it). - b HeartSite Heart info, cardiac tests info, actual diagnostic images. Nuclear/Isotope Stress Test The physician can separate a normal left ventricle, from ISCHEMIA (live muscle with flow that is compromised only during exercise) and the scar tissue of a HEART ATTACK. The distinction is made in...... www.heartsite.com/html/isotope_stress.html b Coronary artery anatomy Starting with the left anterior descending (LAD), the most critical, next to the ultra-critical left main (LM). www.heartsite.com/html/lad.html . i Quote "Be a questioning patient. Talk to your doctor and ask questions. Studies show that patients who ask the most questions, and are most assertive, get the best results. Be vigilant and speak up!" - Charles Inlander, People's Medical S
 
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James_Beckerman_MD responded:
Please note that fixed perfusion defects do not always indicate heart attacks. They can occur in situations in which heart muscle is hibernating secondary to chronically reduced blood flow. A perfusion abnormality can persist from stress to rest in these cases. If further testing suggests that the heart muscle is viable (alive), then restoring blood flow to the affected area using surgery or sometimes stenting can improve heart function.
 
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luciesmommie responded:
I am glad you posted, I just got this diagnosis today and have a reverseible perfusion defect anteroapical wall, EF 45%. More info would be appreciated. Does this mean a cath is in my future and can this be resolved with a cath? I am a retired RN.
 
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CardiostarUSA1 replied to luciesmommie's response:
Hi:

"Reversible perfusion defect anteroapical wall"

Pertinent repost general info excerpt from this thread -

Perfusion defect after exercise, BUT NOT at rest (reversible defect)

There is some degree of blockage in a coronary artery that interferes with the blood flow to the heart muscle. In someone with significant heart disease, when the heart works hard, it does not get the blood supply and oxygen that it needs (a supply and demand mismatch).

At rest, however, the blood adequately reaches these areas or regions, e.g., ANTERIOR/ANTERO (front wall), POSTERIOR (back wall), INFERIOR (lower area/lower wall area), APICAL/APEX (bottom tip of the heart) and LATERAL (side wall).

The heart muscle has living cells/tissue in these areas. This indicates that clearing the blockage in the affected artery will be of benefit.

Additionally, normal resting range left ventricular ejection fraction (LVEF, % of blood pumped out of the left ventricle with each beat) is 50%/55%-70%/75%. Average reported is in the low to mid 60s.

Cleveland Clinic

Understanding Your Ejection Fraction

http://www.my.clevelandclinic.org/heart/disorders/heartfailure/ejectionfraction.aspx

Your Total Health - NBC/iVillage

Ejection fraction

http://www.yourtotalhealth.ivillage.com/ejection-fraction.html

Most important, communicate/interact well with your doctors. Best of luck down the road of life.

Take care,

CardioStar*

WebMD community member (since 8/99)

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-

Be well-informed

Good to know, for the primary and secondary prevention of heart attack and brain attack/stroke

Epidemiologic studies (EDS) have revealed risk factors for atherosclerosis (typically affecting the coronary, carotid, and peripheral arteries), which includes age, gender, genetics (gene deletion, malfunction, or mutation), diabetes (considered as being the highest risk factor), smoking (includes secondhand), inactivity, obesity (a global epidemic "globesity"), high blood pressure (hypertension), diet high in fat, saturated fat and cholesterol, high LDL, high Lp(a), high ApoB, high Lp-PLA2, high triglycerides, LOW HDL (less than 40 mg/dL, an HDL level of 60/65 mg/dL or more is considered protective against coronary artery disease), high homocysteine, and high C-reactive protein (CRP/hs-CRP).


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Quote

"Be a questioning patient. Talk to your doctor and ask questions. Studies show that patients who ask the most questions, and are most assertive, get the best results. Be vigilant and speak up!"

- Charles Inlander, People's Medical Society

.

It's your future......be there. :-)
 
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terryten responded:
how is your mother doing i just found out same condition terry t


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