Cardiolite Stress Test - Interpretation

[paola37]

37 yrs/female/no smoke/no drink/5'5" 150 pound suffering of pvc/pac - Tests done: holter monitors, stress test, cardiolite stress test. Just received cardiolite results -  I'd appreciate y/opinion.

Nuclear Perusion Scan Report:
Following Stress, SPECt images reveal normal perfusion in the entire left ventricle. Rest images show no changes. Polar plots are consistent with these findings. Wall motion study: Gated images reveal normal wall motion and thickening throughout the left ventricle (should I be concerned about this?) Left ventricular ejection fraction is normal; ejection fraction is calculated at 66%.    

Treadmill Stress Test
Protocol: Bruce, METS: 13 - Duration 11:00 - Peak B/P 160/100 - End point: 96%MPHR- Auscultation: No gallops - Maximum Heart Rate 173 - ST changes: 1.5m Upsloping.

Test was terminated because of fatigue.  no chest pain. Patient develped 1 to 1.5mm ST segment depression, upsloping, but without symptoms. These EKG changes resolved promptly in the immediate post-exercise period. No arrhytmias.  

Would appreciate your overall opinion and information about thethickening throughout the left ventricle and the st segment depression - are these two factors linked? Are they the precursor of something else? What does it mean?

All other test that were performed confirmed evidence of multi-focal  PVC/PAC - all other findings are normal.
Thanks for your time.
paola

[CCF-M.D.-CRC]

Dear paola,
A cardiolite stress test is used to determine if there are blockages in the coronary arteries that may be causing your symptoms.  The good news is that your test results are all normal.  Your doctor will go over the results with you and discuss what your best options are next.

[paola37]

Hi again, good to to hear from you. Thanks for your feedback - How can I find out the measurement related to thickening of the left ventricle? This are some the measurement that I have from a past Stress Echo:
Lv diastolic dimension 4.4 - normal ranges: 3.5 - 5.5 cm
Lv systolic dimension 3.0 - normal ranges 2.5 - 4.0 cm
IV septal thickness 0.97 - normal ranges: 0.7 - 1.1 cm
LV post wall thickness 0.9 - normal ranges: 0.8 - 1.1 cm
RV diastolic dimension 2.5 - normal ranges: 0.7 - 2.5 cm
Left atrial dimension 3.9 - normal ranges 1.9 - 4.0 cm
Aortic root dimension 3.0 - normal ranges 2.0 3.7 cm
Pericardial effusion - none

Doppler
Mitral E=0.7 - normal ranges: 0.8 - 1.3 m/s
       A=0.6
Tricuspid 0.6 - normal ranges 0.3 - 0.7 m/s
Pulmonic 0.7 - normal ranges 0.6 - 0.9 m/s
Aortic 1.3 - normal ranges 1.0 - 1.7 ms
LV outflow 1.1 - normal ranges 0.7 1.1 m/s

Actually on the result of this test above, the doc found  a slight thickening of the mitral valve leaflets and not a thickness of the left vetricual - go figure- in any case I am still running - up to 4 miles a day and lifting weights. I am still on Toprol - I am afraid to stop - pvc and pac are most noticeable when I am tired or get little sleep - ... as for you going to medical school...it is never too late to make a dream come true - go for it. Best of Luck and thank you. Paola

[Addie]

I was very impressed with your comments here.

I am unable to get on this site so i hope you can help me.

6 months ago, I had the Dobutermine Stress Echo.  It was done at the texas heart Institute and there was one main cardiologist and 2 fellow cardiolgist and the echocardiographer and a lady at some machine in the room.  This test was ordered before knee surgery as i was unable to have a regular threadmill test due to a bad knee.

I have on and off angina type pains and also some shortness of breath so the orthopedic Doctor wanted this test.

I have never seen the results. When the test was finished the main cardiologist said it looked good with very good pictures.

They faxxed the orthopedic doctor and told him "no ischemia" and there was something also noted: 1. "Reached 88%" and 2. LVOT Obstruction.  Does the words "no ischemia" mean the heart arteries are clear"?  Is this a good test?

Should I be concerend about the LVOT obstruction?  I have e-mailed and called the cardiolgists office 4 times and no one gets back to me.  

I would also like to know if the Dobutermine Stress echo can rule out Congestive Heart Failure?

Thanks so much if you can help answer these for me.  I am 56 years old.

Lisa

[Addie]

Thank you Hankstar for posting back.

Tomorrow, I will be aggressive and get to the botton of this and find out what all this means even if it means I spend the day waiting in someone's office for 'peace of mind'.

Thanks so much.

Lisa

[mmumford]

I have a similar story.

I am a 31 yo male, very active and was recently married in October 2001. I had been taking a product called Hydroxycut for a while and then on January 8th, 2002, I became light headed and felt like my heart was racing. We went to the urgent care and they kept me all night doing 3 EKG(s), 3 Ensigm tests and a nuclear blood flow. They found nothing and I was discharged. A week later I had the same symptoms. They did another blood test and one EKG and found nothing. The doctors told me that the product in the Hydroxy cut (ephedrine) can act like a catalyst to cause anxiety and these symtoms. I have quite the hydroxycut and have been to my regular docotr several times to get more testing done and he is saying I am ok. However, I sometimes feel these pinching type pains in several place on my chest. Sometimes on the strenum, then on the richt pectorial and then at the base of the left pectorial. My doctors says that this is most likely muscular. They are not all the time, but often when I am sitting at my desk. I guess my mind is still conecting the events at the ER with chest pains. I was also told by another Doctor that it was muscular and that a 10 day regiment of VIOXX my be able to ease theses pinching pains. Any thouhgts?????

***@****

[Addie]

Hello there.  I became agressive and a little mean in requesting the copies of my Dobutermine.  She was not going to send them to me as the doctor is out of town for a week and she wanted to wait. I told her that i have waited 6 months now and will not wait any longer. I had to e-mail her a request to get this faxxed to my e-mail fax.  This was 2 hours ago.  

I called another doctor's office at THI and they were WONDERFUL  I explained what I have been thru and was concerend about the LVOT Obstruction seen on the dobutermine test.  They asked me to again call the Cardio's office and have that cardiolgist explain to me what is going on, get a copy of the records, and if i am still not pleased with him and their office, then they will see me. Very professional office.  

MMumford, I cannot take Ephrinephrine as this will cause heart racing (palpatations) and dizziness for me.  I saw 2 doctors at various times after this was given to me at a Dentist's office.  no one had a clue.  I found out years later that EPI causes this.

Do not know about Vioxx...but if you are having spasms, pls. ask your doctor if you can try Ibuprofen, (Advil, Motrin) first as this is an anti-inflammatory med. I too suffer with quick like spasm in the sternum/rib cage.  No fun.

[Druhna]

All your info on Cardiolite has been very informative as I am having the test in a week, but no one spoke of the length of the test, any side effects to watch for or if one can drive themselves to and from the hospital. I am scared to death! Could someone please inform me of what I should expect. Thank you VERY much!

[Fresca]

Just wanted to let you know my husband recently had a Cardio-lite (Thalium, in his case) stress test at Dartmouth Hitchcock Medical Center in New Hampshire.  Although somehwat apprehensive prior to the test (he is not big on medical intervention of any kind) he felt the test was really quite easy and said he was so glad he finally went through it.  On the test day, he arrived early at the facility and had some base-line EKGs and other minor tests done.  Then they put an IV needle into his hand and put in the tracer (Thalium, I assume). Then he had to walk around the halls awhile to get the tracer into circulation.  Next he ran on the tread mill to his comfortable maximum effort.  Then they used some type of machine that looked at blood flow in (to?) his heart by focusing on the Thalium concentrations.  That was about all for him.  He was in and out in about two 1/2 hours and although I went with him to chauffeur, he drove us both home (a 1 1/2 hour drive).  He remarked that for him it was an easy, interesting and reassuring test.  (So far, so good with his heart and arteries despite a poor family history with such things)  I believe you can get booklets describing the procedure from your doctor and there are sites on the internet that describe it, as well.  In addition, you might try calling the facility where you will have the test done and ask to speak to a nurse who works in that department and ask them to tell you everything that will happen, step by step, so you know what to expect and some reassurance.  Good Luck!

[Addie]

My Dobutermine Stress Test (the dye) was about an hour and a half.  I felt warm with the dye going in but was able to drive to and from myself.

My son in law had the thallium (cardiolite) two weeks ago after having a small heart attack 6 weeks ago. (37 years old) This test lasted about 3 hours. He drove there and back himself.  Last Thursday we went for another opinion with a new doctor at a large heart center bringing the Thallium results with us.

This new heart doctor wants the Thallium repeated at the Heart center. My son in law has not decided if he wants to go thru another 3 hours of this so soon.  Plus, he is concerend that the insurance company may squak for a repeat so soon. My concern now is if some centers do a better job than other centers in heart testing.

Good Luck to you.

[pikamom]

I had the thallium test and the worst part was having to lay still while they took the pictures.

[broadway Joe]

I had open heart surgery 2 months ago and recently, I have been experiencing Angina and tightness in the chest. The cardiologist ordered another angiogram and results showed another blockage further down in the heart. He said it was nothing to worry about.
  I then had a thallium stress test which I found very difficult and could only get my HR up to 120 and then the test was stopped. I am waiting for my results from the test which was 4 days ago.
   Further, I have hypertension, Alpha One, and COPD.
    Should i worry about the test results not forthcoming from the doctor .

[broadway Joe]

I had open heart surgery 2 months ago and recently, I have been experiencing Angina and tightness in the chest. The cardiologist ordered another angiogram and results showed another blockage further down in the heart. He said it was nothing to worry about.
  I then had a thallium stress test which I found very difficult and could only get my HR up to 120 and then the test was stopped. I am waiting for my results from the test which was 4 days ago.
   Further, I have hypertension, Alpha One, and COPD.
    Should i worry about the test results not forthcoming from the doctor .

[broadway Joe]

I had open heart surgery 2 months ago and recently, I have been experiencing Angina and tightness in the chest. The cardiologist ordered another angiogram and results showed another blockage further down in the heart. He said it was nothing to worry about.
  I then had a thallium stress test which I found very difficult and could only get my HR up to 120 and then the test was stopped. I am waiting for my results from the test which was 4 days ago.
   Further, I have hypertension, Alpha One, and COPD.
    Should i worry about the test results not forthcoming from the doctor .

[Hyman930]

A related discussion, repeat of cardiolite was started.