Cardiolite Stress Test Results

[lastwrites]

Hello ...

I am a 54-year-old overweight woman.  Five years ago I had a cardiac cath which showed a 50% blockage in one of my arteries (on the left) and 40% in another (on the right).  The test was ordered because I was having terrible chest pains from coughing (severe bronchitis) and my doctor wanted to check the condition of my heart because my EKG had changed considerably since the last one I'd had a year prior.  No treatment was ordered for the blockages except to quit smoking.

I started having what seemed to be bad heartburn and stomach pain not too many weeks ago, especially after eating, and an achy feeling in my chest.  (Cat scan of my abdominal area showed nothing.) In light of the cath results 5 years ago, my doctor ordered a thallium (actually cardiolite) stress test.  I was able to reach 88% of my target heart rate in the test (85% required for accuracy I believe) before I started running out of breath.  If I hadn't quit smoking 2 years ago I probably wouldn't have made it through the last minute!

Anyway, the tests results showed a 15% decrease in blood flow to my heart during stress exercise and no restrictions at rest.

My question is: How does the 15% reduction in blood flow equate in comparison to the 50% and 40% blockages discovered 5 years ago?  Or is there no correlation?

Thanks lots!

[Cleveland Clinic]

lastwrites,

interesting name i must say. thanks for the post.

A nuclear stress test compares the uptake of the nuclear tracer in different areas of the heart.  15% would mean that one area of the heart has less tracer then other parts. The most concerning cause of this would be a blocakge in a coronary artery. 5 years in a while and your blockages may not be 40-50% any longer.

A stress test is not perfect however, the 15% may be an artifact or even a false positive.  

There are multiple factors involved in the genesis of coronary disease beyond cholesterol, we are in the midst of discovering more and more of them.

Given the fact that you do have coronary disease and now a presumptively positive stress, you should see a cardiologist to further evaluate your disease.

good luck

[lastwrites]

Addendum (may not be relevant, but ...)

My blood cholesterol results have been consistent for all of my adult life and, within a few points, are:

Total cholesterol = 185
HDL = 75
LDL = 45
TRI = 110

I guess cholesterol isn't always the culprit when heart disease rears its ugly head, huh?

[nmc]

Wow, I wish I had those numbers! Even with Lipitor, diet, and consistent exercise program, I don't come close. Were your HDLs that high when you smoked??

[SteveO226]

It seems odd. My palps and PVC's seem to come from nowhere. I just checked out my blood work from a month ago and it seems very good:

Total cholesterol : 134
HDL : 40
LDL : 78
Triglycerides: 78

This is a FAR cry from my blood test of a couple of years ago where I had triglycerides at 467. Diet got rid of that one.

[HealThySelf]

In my experience your HDL score is the best predictor of coronary artery disease.  A woman with an HDL of 75 would normally be at a very low risk for CAD and could probably be expected to live to 95 years old.

Also 40 to 50% lumen reductions are not enough to severely limit cardiovascular ability.

It seems that you know what your problem is and what you have to do about it. You need to loose weight and get in a regimin of daily exercise, if you want to be healthy.  It's time to get serious about taking care of your body.  

Alternately, you can stay fat, avoid exercise, and let medical science try to heal you.  Perhaps they can stick a couple of stents in you.  After they develop restinosis, you can move on to bypass surgery.

Remember that almost all disease is caused by bad habits.  If you walk 10 miles into the woods, you will have to walk ten miles out of the woods.  If you continue with bad habits and expect medical science to heal it, you can go down a bad road.

Best Regards

[janne]

Don't let the fact that you are a woman and that your cholesterol is good fool you into thinking everything is okay.  My cholesterol has always been good, I am active (however, I'm 10-15 pounds over weight), I have no family history of heart problems, no high blood pressure and I'm a 39 year old female who was diagnosed with CAD a couple of months ago after having a heart attack. Like you, the only risk factor I had was that I am(was) a smoker.
I am not trying to scare you but just wanted to warn you that if you know you have CAD already you are already one step ahead of the game.  Don't do like I did and ignore symptoms thinking, "it couldn't happen to me".  If you listen to your body, you may just save yourself a heart attack.
Good luck.
Jann

[lastwrites]

Thanks for all your comments.

NMC - My cholesterol numbers were the same even when I smoked.

STEVEO226 - I still have irregular heart beat that has unexplained origins.  I was told by the doctor who performed by ablation for  SVT that there are many causes for irregular heartbeat, most of them still unknown and none of them consistent.  I notice mine mostly at rest, but tests indicate that mine are not life threatening.  Doesn't feel like it though sometimes.

HEALTHYSELF - Yes, I know I need to lose weight.  I struggled for so many years to quit smoking that I thought I'd get a couple of good solid years of no smoking under my belt before I addressed my weight issues.  I feared that putting too much stress on myself to lose weight would risk my smoking cessation.  I have already lost 15 pounds and hope I can stay focused enough to not falter.  I've changed my eating habits drastically and started to exercise more.

JANNE - Actually, I've got a pretty good grip on reality and realize that heart attacks can happen to anyone.  Most people don't even know they have a problem until a heart attack occurs.  I probably fall to the "obsessed with the health of my heart" side of the spectrum and am constantly wondering when a heart attack will hit.  Since I posted my original question, I've had an evaluation of my stress test and am having follow-up testing done.  I also discovered that the 40% and 50% blockages discovered five years ago were in "branch off" arteries, not the main arteries in my heart.  However, CAD is CAD no matter where it occurs, so I have to make some changes.

I have eliminated all cholesterol from my diet (which means no meat) and am staying under 10 grams of other fats a day (no saturated fats except for minute amounts that are found naturally in plant sources) which leaves mostly vegetables, fruits, grains, legumes and such to work with.  It's a drastic change and I hope I can stick with it.  My cardiologist is setting up a meeting for me with a nutritionist who will help me to choose and eat the correct combination of foods to ensure adequate protein, etc.

Other than making food and lifestyle changes, and listening to my doctor, there is very little else I can do.  I have to take the attitude that if I have helped myself in all ways humanly possible, I can do no more except to trust God for the rest ... whatever that may be.