Cardiac Ischemia and infarct

[AshleyBaker]

Hi. I'm an RN with new heart problems. I have had several CV tests done: ECG, event monitor, US, CXR, dabutamine stress test (terminated due to inability to tol the adverse effects), nuclear study of adenosine and cardiolite stress test over 2 days. I also had PFT's done and some labs drawn, none of which were cardiac. Anyway, the US showed an abnormal shaped L ventricle. There was some wall thinning as well (mildly low). But the last test, the nuclear study showed I had a small infarct and medium amount of ischemia. What does that mean? I had a heart attack and there is heart muscle damage. Right? My dad thinks that my breast implants could have yielded a false positive. I disagree because I have been symptomatic with SOB and CP, plus this was a NUCLEAR test. Does this mean that I may have CAD and a blockage? I have been SOB all day today, is this part of it? Sorry, only answer what you can. I'm nervous about knowing too much. Will be calling the MD in the AM. Thanks,

Ashley (nickname here on this site)

[Lee Kirksey, MD]

Hello
It sounds like you have had a very extensive cardiac evaluation. Without knowing your cardiac risk factors ie, hypertension, cholesterol, insulin level, family history, body weight and age and results of the tests, it is impossible to make a specific comment regarding your broad, overall cardiac health.

I think that youre saying that your new heart problems are shortness of breath and chest pain. You are correct that the cardiac stress test with infaction is indicative of old irreversible damage to the heart muscle. While the ischemic area suggests reversible areas of low perfusion o the heart muscle that is seen with increasing effort of the heart.

One of the common causes of ischemia and infarction is related to blockages within the blood vessel although other disorders like damage to the heart muscle itself (cardiomyopathy) can cause similar findings. Obviously, the SOB may be part of it or it may be related to the anxiety of dealing with the medical condition

Regardless, Im certain that they would not have sent you home if they thought that anything were acutely dangerous. I would suggest that you write down your questions so that you will be prepared to ask them to your heart doctor tomorrow when you speak about the test results.

Going back to your risk factors, take this opportunity to assess your cardiac risk profile and use the motivation to make important lifestyle improvements

Good luck

[AshleyBaker]

Awesome information from this doctor. I wanted to add that I spoke to my cardiologist today and he said that it IS possible to have a false positive on a stress test, nuclear, as well. But since I still have symptoms, he suggests a cardiac cath which is in my future. For the record, I am 41, a history of hypertension, gerd, IBS, bipolar (incluse anxiety), and sjogren's syndtome. I have recently lost 35 lbs through a medically managed bariatric clinic by loosing weight over a years time (no surgery). My BMI is 29. I am considered overweight, but no longer obese. I do not exercise daily and I eat a fair diet. I do not drink alcohol and I do not smoke.

Thanks for the help doc.

Ash

[Lee Kirksey, MD]

Good luck with the cardiac cath. I hope the stress test was a false posititive. Keep up the good work with your lifestyle improvements