Don't Understand My Husbands Nuclear Stress Test Results

My husband recently had a nuclear stress test done and the results are confusing. They are as follows: Excercised using full BRUCE protocol for 14 min. Pt achieved 17.2 METS, max heart rate of 184bpm of 177/75 mmHg. The double product was 32,568. Pt has no chest pain. He had TWI inferiorly and on V3 to V5 that resolved in recovery. No ST changes. It then goes on to say that there is attenuation due to soft tissues of the chest wall. There is diaphragmatic attenuation. Post excercise SPECT images of the heart demonstrate a small area of mildly dcreased radiotracer activity in the anterior wall which reverses when compared with rest images, and is suggestive of ischemia. This is the part I am really worried about. I am also concerned about the following result: There is a large area of mildly decreased activity in the inferior wall that is fixed, when compared with rest images and has normal wall motion. This is most likely due to soft tissues attenuation. What does that mean? It also says that images show normal left ventricular wall motion with an estimated post-stress left ventrucular ejection fraction of 54%. I am very concerned, does my husband have anterior wall ischemia or should we ask for more testing?

[kenkeith]

QUOTE: "There is a large area of mildly decreased activity in the inferior wall that is fixed, when compared with rest images and has normal wall motion. This is most likely due to soft tissues attenuation"

Soft tissue attenuation is one of the more common causes of an imaging artifact. The heart is surrounded by tissues of varying densities (eg, bone, lungs, and breast). Unpredictable artifacts may arise when the body build , physique, differs significantly from expected gender-specific patterns. Nonuniform photon are due to intervening structures attenuation and the resultant artifacts are affected by several factors, including:
Body size, depth of the heart in the body, and  gender.
.
Your husband did very well with the stress test and no chest pain (angina) is evidence there is no ischemia.  The EF is in the normal range (normal is 50 to 75%) and reflects the amount of blood pumped into circulation with each heartbeat.  I see no cause for concern regarding your husband's heart functionality based on the report.  

[cspann21]

Thank you so much for your explanation, it really helped my understanding of the issue.

[kenkeith]

My pleasure.  Take care.