Hi, I'm a 50 yr old male, juvenile diabetic since 1975(for 37yrs), and recently did the Stress Echo-Treadmill exercise due to occasionally shortness of breath. (Note:Seek an 2nd opinion a few days ago and the Dr indicated that my description of breathlessness could be caused by anxiety instead of Heart problem as I've history of consumming Finasteride(propecia) and Proscar for my hair growth)
The Rest Echo Findings shows: The midinferoseptal, apical anterior & apical inferior wall segments are hypokenetic(score 2). The apical septal wall segment is akinetic(score 3), the remaining wall segments are normal(score 1) and Overall wallmotion score index is 1.31.
Left Ventricle: LV cavity size and LV systolic function are Normal. calculated LVEF of 55%(by Modified Simpson Method). regional wall motion abnormalities(summarised above). No left ventricular hypertrophy.
Right Ventricle: normal RA cavity size. Normal RV global systolic function. TV annulus excursion is 2.7cm. TA S wave 0.15m/s. TA E' 0.13m/s. TA A' 0.18m/s.
Left Atrium: Mildly dilated LA cavity. Calculated LA volume of 58ml.(Modified Simpson Method) Idex LA volume of 29ml/m2.
Right Atrium: Normal RA cavity size. RA area 14cm2
Stress Echo Findings shows: No new RWMA at 105% of maximal, age-predicted heart ate. LVEF increased from 55% to 70% with stress. LV volume decreased at peak stress.
Conclusion: Negative Exercise Stress Echo for inducible myocardial ischarmia at 105% MPHR. RWMA at apex at rest remains unchanged after stress. No new RWMA noted.
Negative stress ECG for inducible myocardial ischarmia at 105% MPHR.
No chest pain. No arrhythmia. Appropriate heart response. Appropriate Blood Pressure response.
My Dr. arrange me for Coronary Angiogram and Angioplasty.
I'm really lost and concern and appreciate any advise.
Your stress test seemed to be fine, and you don't appear to suffer the usual symptoms of Angina. The Echo has shown abnormal heart wall movement, so an angiogram is to check if there are any blockages in your arteries. The wall which separates the left and right ventricles is the main issue here. Part of it is hypokinetic, another part is akinetic. Hypokenetic means it is not moving as quickly as it should, usually a sign of a blockage. Akinetic means not moving at all, usually the result when someone has had a previous heart attack. An angiogram will be a very details analysis of your coronary arteries.
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