After a recent stress test, the nurse sent me a report that says, "Abnormal Cardiolite images reveal a small region of moderately decreased uptake in the inferoapical region during stress and resting without evidence of reversibility. ..... minimal inferoapical hypokenis..... No evidence of eschemia...... Calculated ejection faction is 72%."
She said the report "is not good" and I will have to talk to the doctor when he returns in a few weeks. I did not have any trouble during the stress test at all. As an avid walker, I got into the 3rd stage of the stress test and the doctor ended it saying that he has all of the info that he needs.
Since my doctor will not be available for several weeks, can anyone interpret this in plain terms? Many Thanks
"Abnormal Cardiolite images reveal a small region of moderately decreased uptake"
The SPECT scanner has the ability to properly read/count the amount (or lack thereof) of IV administered radiotracer (such as Cardiolite or Myoview) that is taken up (uptake) into the heart muscle.
Isotope/Nuclear Stress Test
SEE: Actual rest/stress nuclear images
The physiciancan 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 the following way......
hypokinesis = low or reduced wall motion or contractility, which can occur in one (regional) or more areas of the heart. Even the entire heart (global) may/can become affected.
"No evidence of eschemia."
Cardiac or myocardial ischemia us an insufficient amount of blood flow and oxygen to the heart muscle.
"Calculated ejection faction is 72%."
Ejection fraction or LVEF is the amount of blood that is forced out of the left ventricle (LV) with each beat, the single-most important clinical indicator of how well the heart is pumping. LVEF can vary from one type of diagnostic imaging modality to another.
The two main concerns regarding a nuclear stress test involves an actual (not a false image or artifact) 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), 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 -
No perfusion defect after exercise or at rest
The heart muscle and blood flow to the heart muscle appear to be normal.
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.
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.
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.
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The general goals of a stress test is (1) to try to detect coronary artery disease and evidence of prior heart attack and (2) to try to determine overall prognosis.
Whenever there is "decreased uptake" of the radioactive tracer in the heart, that can be suggestive of a prior heart attack or a coronary blockage, but can also occur as a "false positive" in people without heart disease. That's why it's important to discuss your test results with your doctor.
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