Cardiac Stress Report

[Connie651]

I have had a very mild heart pain for many years.  It never occurs during exercise, always at rest.  Numerous doctors have told me it was musculoskeletal but I have always worried about it.  My father passed away from a heart attack at age 57 and my mother had bypass at age 65.  I do have trouble managing my weight (200 lbs at 5 ft 6 in) but my blood pressure and cholesterol have always been very good.  I discussed this with my doctor again in January and she ordered a cardiac stress test with the echo.  I was surprised to find that I failed the test.  Conclusions:  "Borderline hypokinesis mid & apical lateral segments.  Echocardiographic evidence of ischemia.  Exercise stress test without ECG evidence of ischemia.  Abnormal regional wall motion with stress.  Post exercise wall motion shows hypokinesis involving the mid lateral and apical lateral segments.  There is normal systolic function at rest with a visually estimated EF of 60%.  At peak stress, EF is normally improved."  I do not know what any of this means and how serious it is.  I am scheduled to see a cardiologist tomorrow.  Can you help me understand what is happening?

[kenkeith]

Borderline hypokinesis means there is heart wall movement impairment at the location stated.  If serious the systole function (pumping phase) would reduce EF (ejection fraction...the % of blood pumped out with each heartbeat) and the EF would be less than normal (normal 55-75%).  The test indictes some vessel blockage (ischemia).

Hypokinesis is usually the result of a prior heart attack that has damaged the heart cells?!

You may ask the doctor how there can be less pain when exercising than at rest.  Ischemia shown during a stress test occurs when the exercise (stress) demands more blood/oxygen, and because there is ischemia, the demand is usually more than the heart vessels are able to pass on so the result is angina (chest pain).