Confused...

[evegirl]

hihi
i am a 36 yr old woman with a strong family history of heart desease and angina.
my grandparents on both sides all dealt with high blood pressure and or heart desease.
a year ago i began experiencing chest pains that would leave me sweating and gasping for air.
it felt like a knife was beign driven into my heart and would radiate up into my neck, jaw, behind my ear and across and down my right arm.
i went to my dr and he sent me for many tests including a stres test and the test where they inject you with the pink radioactive stuff. Stress Midi?
i finally got to look at the report yesterday and quite frankly im confused.
here it what it says..

ECG lasted 5 min 36 sec. workload is 7 METS whcih is dysfunctional class 1. usual chest discomfort but not significant ST segmant changes.
follow up scan showed mild heterogeneity in uptake with minimal decrease twoards the anterior wall. there isthe appearance of a defect in the inferior wall as well. her ventricular function and ejection fraction is 60% and no segmental wall motion abnormalities.

ok what does this mean in english please! hahaaha
should i be worried?

thanks for any info

[CCF-M.D.-MJM]

Hi Eve,

I will try to break the report down.

Exercising for 5 m 36 sec to 7 METS means you are likely not very fit.  The number METS (metabolic equivalents) required to walk is between 3.5 and 7 METS.  If you exercised to your full capacity, you are in the bottom quartile for your age and gender matched patients that can probably exercise to about 10-13 METS.

minimal decrease towards the anterior wall.

this is likely decreased because of breast attenuation.

Appearance of a defect in the inferior wall

This may be related to decreased blood or artifact from your stomach or liver.  The likelihood of this being a blockage or artifact is up to your symptoms and your doctor’s discretion.  The next step would probably be a CT angiogram or a left heart catheterization.

I am concerned about your low exercise capacity and what the causes may be....are you overweight, out of shape, lack of effort on test day, or whether this may represent a medical problem.  In all likelihood, it was one of the first three answers, but I cannot rule out from what you have told me here today that it could be medical.  That is where meeting you clinic makes the difference.

I hope this answers your questions.  Good luck.

[Barbarella]

Anacyde, I understand about your grandma.  My grandma too had heart problems and severe hypertension at times (280 syst)which all started when she was in her early 50's and she died in her sleep at the age of 83.  She never was on any kind of meds for her heart or BP.  I don't know if they didn't have any BP meds back then (1920's and 1930's when it started) but I remember as a child when going to the doctor with her in the mid 1950's him saying "don't upset your grandma her heart can't take it" or he said at times "grandma's BP is very high don't upset her".  Was she and others like her an exception not getting a stroke or a heart attack?  A relative of mine had always low BP and died of a stroke at the age of 70 it took the neurologists forever to find out why the stroke.

[Barbarella]

YES, YOU'RE SO RIGHT mindset has a LOT to do with it.  Also back then people didn't worry about symptoms as they worry now because they didn't constantly have the commercials in their face telling them "what a walking time bomb they are".  When I was a young child hearing somebody having a heart attack or stroke was VERY BIG news now a days its the norm.  I think I remember ONE person having a heart attack in our community throughout my first 20 yrs living there, and it was a pretty big community. The diet people had back then Cardiologists would stroke out over now a days.

As for the mindset, I know of people and people in my family who are in their late 30's and early 40's and already say "we are to old for this and that" and they're NOT joking.  I'm 61 yrs old and feel like I'm 30.  I have more energy than people half my age, and I'm not talking about nervous energy, and I do suffer from an anxiety condition since the age of 15 but wont let that get me down, there are always worse things in life, I could be sitting paralyzed in a wheel chair.  

My husband doesn't worry about anything which I do, he pops his BP pill with a 6 pack for years and all his medical tests come out excellent.  He says "if I die, I die why worry about it we all have to go some day" :)

[Barbarella]

I know how you feel about meds.  I NEVER took any meds until I had this high BP emergency so now I've to take BP meds, but was scared to death of statin drugs. Was put on Zocor and scared the hell out of me.  Did you ever read the fine print on the back pages in the magazines they are advertised in? Or go on the Internet and type in the name of the meds and right beside it "side effects" this is enough for anybody to throw in the towel. Or read the fine print on the inserts which come with the meds.  Give me a break!  You take one medication for something and then you have to take another for the side effect of the first meds you are taking. The info on the Internet is written mostly by medical people but when I tell my doctor about it or god forbid bring him the exact page from the net he gets mad and says "don't believe anything you read on the Internet" yet doctors, pharmacists etc print/write this stuff.  Hello!

[Barbarella]

Yes, I know all about statistics.  I used to work in the Neurosonology dept. at a large teaching hospital for many years as a medical secretary and machine transcriptionist, I typed the dictations of all the patients coming in and therefore was informed what the Neurosonologists found i.e. whether the patient's arteries were clogged, how much or not clogged at all, and I was very interested in the patients Cholesterol levels since I have high Cholesterol.  Once they came to us they already had the angiograms done to see if they have blockages, which lots of them did not, then they came to us to have their carotid arteries scanned.  We had patients coming in with a total Cholesterol over 1000 and they had totally clean arteries both their hearts and in their necks, these were older patients people who ate fat back, pork and all the wrong stuff all their lives.  Then we had people coming in with a total Cholesterol of 159 for example (this was before the statins) and they had strokes.

A friend of mine was on statins for almost 10 yrs with her Cholesterol dropping down to 130 for many yrs and she recently had to have a bypass surgery done. When she was put on statins her Cholesterol was 210.