Circumflex artery calcium -versus stress ECG .

[Mike501]

Hello !
I have a 1 year history of chest pain .
I recently had a Stress Test Echo description of which
is:LA37mm LVIDd 48mm , LVPW(ed)7mm, IVS 7mm,aorta 31mm
LVmass 120g.
Valves
MITRAL :anatomically normal mitral valve.Minimal mitral       regurgitation(may be within normal limits)E/A=1.6.
AORTIC :Normal three leaflet aortic valve.No evidence of insuficiency
TRICUSPID:Anatomicly normal tricuspid valve.Minimal tricuspid
regurgitation(may be within normal limits).Unable to estimate
right ventricular pressure.
PULMONIC:Anatomicly normal pulmonic valve.No evidence of insufficiency.
I achieved 13 mets in the stress test
Observations/conclusions where/
HORIZONTAL ST 2mm DEPRESSION IN THE INFERIOR AND LATERAL LEADS .
ST segment normalizes @1:00 of recovery .Probability of CAD.



I also had a test Coronary Artery Scan for Calcification
which revealed that I have 0.0139 cc's of calcium in my circumflex artery.My question is which ECG leads are
able to give information about the possibility of ischemia
in the circumflex artery are them the inferior and lateral leads?
thank you for answer

[CCF CARDIO MD - DLB]

ST depression seen on an exercise ECG is not useful for localizing which artery may have a blockage - this is a common misconception, even among doctors. It only gives a probability of having or not having coronary artery disease in one or more coronary arteries. Your exercise ECG sounds like it was abnormal, but the echo part of the stress test should give a more definitive answer about whether there is a significant blockage in the coronary circulation. The calcification indicates that you do have coronary artery disease, but does not assess the severity.

[Echo Tech]

You did not mention how the post stress echo images turned out.  The circumflex artery provides flow to a specific area of the myocardium.  If the disease is hemodynamically significant, the muscle response to stress would be abnormal.

[Michael to echo tech]

Based on multiple ECG's that I had the changes are interpreted as :deoxygenation of the left atrium.I am trying to rule out
which is more likelly causing the problem: the regurgitated mitral heart valve E/A=1.6 or the "trace" volume of calcium that was found by CTSCAN.I know that changes in ST-T interval
especially in it's depression can be caused by both coronary artery disease and they can be a result of leaky valves.According to "Hurst's THE HEART" those diffirences can be ruled out by the ECG leads .In morphology of ST segment the depression indicates ischemia ,elevation -an infraction.For example infraction of the LCD is represented by electrode elevation at V1 and V2; infraction of the circumflex is represented by  V3 and V4 ;RCA and Circumflex infraction are supposed to be represented by V5,V6,I,aVL.
I realize that the origin of ischemia can be found without the "Golden Rule" Coronary angiography or a invasive echo,in my case
I believe that there is a way of associating those symptoms
(ST abnormality,chest pain ) with either coronary calcium
or mitral valve regurgitation.
Sincerely
Michael

[Allen C.]

What exactly is an echo cardiogram; and what does it specifically test for?
Thank you!

[Michael]

Hello !
I am not a doctor however the ECHO or Echocardiogram
refers to ultrasonic (sounds with very high frequency which bounce off in order to interfere with the material and after detection images can be produced.
It allows to see :internal structure of the heart,valves
and it's functioning .It allows to see the flow of blood
through the heart.There are several types one of which is TEE trans espophageal allowing to get better images of any defects on the heart valves .
There are several publications that you might consider reading
if you are interested in Echocardiography.

[connie]

I am a 45 yr. old female.In the past 4 months I have had nagging pains shooting upward from the left side center of the top of the chest. It comes and goes  and its getting more often and athe pain seems to be a littel more intensed. There is no shortness of breath but I've noticed a tingling or a flushness to my face. People have even comented that I looked flushed. I tend to flush when eating certain furits but this is happening when I'm not eating fruits. Have any suggestions?

[PATTY]

Echo stress test can not rule out cornary artery disease. I had this test and it was normal " NO evidence of Cornary Artery Disease". One week later I had a very severe MI,there was a 100 Per cent blocakage of the circumflex artery. The pain I was having for  a month before the MI and with the MI was only in my Jaw. No chest pain. I did have a lot of shortness of breath. The bottom line here is, if you have symptoms, keep getting test even if they all come back normal. Only an angiogram can actualy see a blockage, and even this is sometimes wrong.

[Jackie Little]

What is a angiogram? How is it performed?

[Jill]

My mother has stenosis of the aortic valve.  Her heart surgeon has said the aortic valve has a gradient of 150 (!).  He has never seen a patient with such a tight valve before, and yet she is only suffering from breathlessness if she has walked too far, or goes upstairs.
She is not suffering from any other pain or angina.  He has told us that without an operation the aortic valve will kill her (his words),
However, we have now been told that the risks have increased, because on a recent scan, the aortic artery has calcified.  During the process of the operation, the aortic valve would have to be clamped and therefore crack the calcium leaving deposits in her blood stream and therefore increasing the risk of a stroke on the operating table or later.  Her surgeon says the risks have increased by a further 20%.
Question -  do we go ahead with the operation anyway or let nature take its course......any help or advice would be gratefully received.
thank you