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son_pri posted:
Could you please explain the following in simple terms:
Exercise MYOVIEW cardiac SPECT at 85% predicted HR and 4.8 METS with nitrate enhancement is negative for inducible ischemia or hibernating myocardium.

There is an evidence of large sized fixed perfusion defect of high severity involving distal 2/3rd of anterior wall, apex, septum and apical inferior wall with evidence of apical aneurysm (full thickness infraction).

Kindly suggest measures for improving heart and life condition.
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cardiostarusa1 responded:
Hi:

"Evidence of large sized fixed perfusion defect "

Fixed perfusion defect = heart attack

"Distal 2/3rd of anterior wall, apex, septum and apical inferior wall"

Anterior = Front wall, apex = bottom tip, septum = dividing wall (separates the right side of the heart from the left side), inferior = lower area

"Evidence of apical aneurysm (full thickness infarction)"


The term aneurysm typically describes an enlargement or ballooning out of an area of the wall of a vessel/artery, but can also occur in the heart wall or heart chamber.

Full thickness infarction = Q wave MI (myocardial infarction), the worst kind.

The Basics

The two main concerns regarding a nuclear stress test involves an actual (not a false image or artifact) narrowing or scarring, that is, the findings of reversible (ischemia) or non-reversible (fixed, permanent, scar tissue) perfusion (blood flow) defects.

After stress myocardial perfusion imaging (stress MPI with Cardiolite or Myoview), the patient'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 'n demand mismatch).

At rest, however, the blood adequately reaches these areas or regions, e.g., ANTERIOR/ANTERO (front wall), POSTERIOR/POSTERO (back wall), INFERIOR/INFERO (lower area/lower wall area), SEPTAL/SEPTUM (dividing wall), 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/areas of the heart muscle that has become scar tissue (scarring, scarred) because of the heart attack.

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 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.

HeartSite

Isotope - Nuclear Stress Test

SEE actual rest/stress images.

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

Coronary artery anatomy

Starting with the left anterior descending (LAD). The most critical, next to the ultra-critical left main (LM).


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


Keep ALL known modifiable risk factors for cardiovascular disease closely in-check. Most important, communicate/interact well with your doctor(s), especially when it comes to the results from any diagnostic imaging tests.

Best of luck down the road of life.

Take care,

CardioStar*

WebMD member (since 8/99)




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Heart-Healthy Foods

Nothing complicated

AVOID foods high in saturated fat and cholesterol. CHOOSE skim or low-fat milk, low-fat yogurt and reduced-fat cheeses. Eat more fish and poultry. LIMIT servings to five to seven ounces a day. TRIM visible fat. Limit egg yolks. SUBSTITUTE two egg whites for one whole egg or use an egg-substitute. Eat more fruits and vegetables, whole grains, breads and cereals. USE LESS salt and fat. SEASON WITH herbs and spices rather than with sauces, gravies and butter

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