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Heart Disease  (Expert Forum)
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thallium stress test
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thallium stress test

by muteone, Jul 20, 2007 12:00AM
Recieved results of thallium. Does it show I have heart disease? what does it all mean?
Impression:
1. no evidence of myocardial ischemia
2. Fixed perfusion defect involving the inferior wall is consistent with subdiaphragmatic attentuation artifact.
3. Fixed perfusion defect of moderate-severe intensity is seen involoving the basilar region of the inferolateral wall, representing approx. 5% of the entire myocardium. this perfusion abnormality is assoc with hypokinesis of the basilar and middle regions of the lateral wall, suggestive of an old infarct or hibernating myocardium, although this perfusion defect is not in a typical vascular territory.
4. Normal left ventricle cavity size, with no eveidence of transient ischemic dilation.
5. Mild hypokinesis invloving the basilar and middle regions of the lateral wall. LVEF of 47%
I want to deploy to antartica but won't be able to if I am a cardiac risk. Help!!!!!

by CCF-M.D.-CA, Jul 21, 2007 12:00AM
There is some variability in the interpretation of your test, as well as in the actual numbers quoted. Not having seen you study I can't say that I agree with this reading, and it is fairly atypical to have a focal wall motion abnormality in a distribution not supplied by a coronary artery. THe base of the heart has more fibrous tissue and if this is not taken into account then one may make the mistake   of calling the wall motion abnormal when it is normal. However a calculated EF of 47% is not normal for a thalium stress test, but once again this is partly subjective on the part of the interpreter.
Remember that any test is not perfect and this test is very far from it. Dependog on your pre test probability of having CAD you may then want to proceed to a cath or PET scan to better view any fixed deffects or viable tissue.
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