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coachspl posted:
I have recently completed a stress test and they have noted an inferoapical defect. What does that mean, how is it treated, and what are the risks involved-long and short term.

Thanks,
spl
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CardiostarUSA1 responded:
Hi:

The question is, was it a reversible or fixed defect?

Inferoapical

Infero = inferior (lower area)

Apical = apex (bottom tip)

The 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.

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 -

1:

No perfusion defect after exercise or at rest

The heart muscle and blood flow to the heart muscle appear to be normal.

2:

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.

3:

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.

4:

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.

Keep ALL known modifiable risk factors for cardiovascular disease in-check. Most important, communicate/interact well with your doctors. Best of luck down the road of life.

Take care,

CardioStar*

WebMD member (since 8/99)

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Be well-informed

HeartSite

Isotope/Nuclear Stress Test

SEE: Actual rest/stress nuclear images

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....

http://www.heartsite.com/html/isotope_stress.html

Coronary artery anatomy


Starting with the LAD, the most critical, next to the ultra-critical LM

http://www.heartsite.com/html/lad.htm l

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Identified risk factors for atherosclerosis includes age, gender, genetics, diabetes, smoking, inactivity, obesity, hypertension, 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!"

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It's your future......be there. :-)

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WebMD/WebMD Health Exchanges does not provide medical advice, diagnosis, or treatment.
 
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Robert A Harrington, MD responded:
Good information is provided by CardiostarUSA. Understanding a bit more about the type of stress "defect" is important in helping to decide what it may represent. But even more critical is to understand why you had the stress test in the first place. Was it to assess chest pain symptoms, shortness of breath or other symptoms that suggest the possibility of coronary artery disease? It's important for your doctor to understand the test in relationship to any symptoms that you might be having. This will help him/her to decide if anything else needs to be done (more tests such as a cardiac catheterization) or medical therapy.

Definitely get follow-up on this from your doctor and good luck.

Bob H


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