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Stress Test Results
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An_253248 posted:
My husband recently had a nuclear stress test and was told he had a slight weakening of the heart and no blockage. When I got a copy and read the results (and from little rearch I was able to do on-line) I am worried that it is really positive for a cardiac disease issue. He had it done for chest pain that that radiated to his left arm and shortnss of breath. I understand these things need to be interpreted by a Cardiologist, but being a non medical person, these results were concerning to me. Should I be concerned and get him to a Cardiologist (was told to follow-up with his PCP). He is only 50 and both his parents had heart disease and had to have open hear bypass surgery. Following is the result:

1. Bruce ex. tol. test positive for 2/10 chest discomfort as well as for inferolateral ishemic st segment depression (1mm of horizontal st segment depression in leads 2,3,AVF)

2. appropr heart rate response to exercise. BP elevated at rest with an exag bp response to exercise.

3. Normal left ventricle cavity size at stress

4. there is evidence for a small fixed inf wall perfusion abnormality which is seen at stress and at rest. No significant reversibility noted. The sum stress score is 3 with a sum rest score of 4.

5.gated SPEC imaging reveals moderately to severely depressed left ventricular systolic function.. There is moderate to severe global hypokinesis. The ejection fraction is 35%.

6. clinical correlation is advised in light of the decreased eejction fraction in a patient of this age.

Thank you.
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cardiostarusa1 responded:
Hi:

"I am worried that it is really positive for a cardiac disease issue."

Worried no doubt.


"I understand these things need to be interpreted by a Cardiologist"

Yes, of course, and obviously in-person.

"Should I be concerned and get him to a Cardiologist (was told to follow-up with his PCP). He is only 50 and both his parents had heart disease and had to have open heart bypass surgery."

The general consensus would be yes.


......"and was told he had a slight weakening of the heart and no blockage."


"The ejection fraction is 35%."

Cleveland Clinic

Understanding Your Ejection Fraction

http://my.clevelandclinic.org/heart/disorders/heartfailure/ejectionfraction.asp


Moderately to severely depressed left ventricular systolic function = systolic heart failure

Moderate to severe global hypokinesis: global = all over, throughout

Hypokinesis = low heart wall motion

"inferolateral ishemic"

"there is evidence for a small fixed inf wall perfusion abnormality which is seen at stress and at rest. No significant reversibility noted."

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.

Best of luck to your husband and you down the road of life.

Take care,

CardioStar*

WebMD member (since 8/99)




-

-

Be well-informed

LEARN ABOUT the Heart


WebMD

The Heart: (Human Anatomy) Pictures, Definition, Location in the Body and Heart Problems

http://www.webmd.com/heart/picture-of-the-heart


How the Heart Pumps


Animated Tutorial

http://your-doctor.com/healthinfocenter/medical-conditions/cardiovascular/heartpump-tutorial.html


HeartSite


Heart info, cardiac tests (commonly performed, mainstream types) info, actual diagnostic images.

http://www.heartsite.com

-

WebMD/WebMD forums DOES NOT provide medical advice, diagnosis or treatment.
 
avatar
cardiostarusa1 responded:
Hi:

"I am worried that it is really positive for a cardiac disease issue."

Worried no doubt.


"I understand these things need to be interpreted by a Cardiologist"

Yes, of course, and obviously in-person.

"Should I be concerned and get him to a Cardiologist (was told to follow-up with his PCP). He is only 50 and both his parents had heart disease and had to have open heart bypass surgery."

The general consensus would be yes.


......"and was told he had a slight weakening of the heart and no blockage."


"The ejection fraction is 35%."

Cleveland Clinic

Understanding Your Ejection Fraction

http://my.clevelandclinic.org/heart/disorders/heartfailure/ejectionfraction.asp


Moderately to severely depressed left ventricular systolic function = systolic heart failure

Moderate to severe global hypokinesis: global = all over, throughout

Hypokinesis = low heart wall motion

"inferolateral ishemic"

"there is evidence for a small fixed inf wall perfusion abnormality which is seen at stress and at rest. No significant reversibility noted."

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.

Best of luck to your husband and you down the road of life.

Take care,

CardioStar*

WebMD member (since 8/99)




-

-

Be well-informed

LEARN ABOUT the Heart


WebMD

The Heart: (Human Anatomy) Pictures, Definition, Location in the Body and Heart Problems

http://www.webmd.com/heart/picture-of-the-heart


How the Heart Pumps


Animated Tutorial

http://your-doctor.com/healthinfocenter/medical-conditions/cardiovascular/heartpump-tutorial.html


HeartSite


Heart info, cardiac tests (commonly performed, mainstream types) info, actual diagnostic images.

http://www.heartsite.com

-

WebMD/WebMD forums DOES NOT provide medical advice, diagnosis or treatment.
 
avatar
James Beckerman, MD, FACC responded:
Thanks for your post - I agree that this should definitely be followed up with a cardiologist. His reduced heart function is an important finding, and further testing and medical treatment may be appropriate.


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