EKG abnormal, Nuclear stress test shows ? possible blockage

[SunnyD2]

ECG (what is different than EKG?) in 2005 said: Abnormal
Rate 86 - normal sinus rythm
PR 123 - Vertical axis, unusal for age (69yrs)
ORSD 85 - Probable Old Lateral infarct
QT 329
QTc 393  AXIS - P 69, QRS 81, T 75

In 2007 said:
Rate 86
PR 153
QRSD 77
QT 372
QTc 445   AXIS - P 0, QRS 78, T 81

Nuclear Stress Test said:
Subjectively positive & objectively equivocal.
Transient left ventricular cavity dilatation noted after injection.  Calculated overall left ventricular ejection fraction of about 77% Reversible anterolateral perfusion defect noted towards the apex.
Dr. just said possible blockage.

I am 71, not overweight, don't smoke or drink but have COPD and get pneumonia easily. Dr wants to do Cardic cath but IF it shows something I am very concerned about possibly being put on respirator and strong possibly of not getting off one. In layman terms what does all the above stuff mean? Dr doesn't say much other than he hopes I will let him do a cath. Help please.

[kenkeith]

A CT scan 64-slice angiogram assesses the entire anatomy of the vascular system and that includes the area outside lumen (cavity) to the intima (innermost and the outer lining.  This area can have a buildup of soft plaque and soft plaque can break through into the lumen and cause a heart attack.  It is well known that most heart atacks result from this situation.  A cath assesses the lumen for blockage that may cause a ischemia (lack of blood flow) to the heart muscle.  

Looking for cardiac pathology includes analyzing chamber size, valve integrity, heart muscle viability and functionality with a calculation of the EF (ejection fraction of blood pumped with each stroke), etc. as does a cath.  But the CT scan also includes an area above the heart (pulmonary location) and below the heart that includes the decending aorta for an aneurysm, etc.

Unable to reply sooner, but hopefully the information is in time for discussion with your doctor.

[Omnistuff]

Thank you KENKEITH for you swift resonse. I'm not sure of the portion of your answer, "dx vascular and cardiac pathology."

Do you mean that the CT scan 64-slice angiogram is an option to the cardiac cath procedure?

[kenkeith]

CT scan 64-slice angiogram is another option to dx vascular and cardiac pathology.  

[Omnistuff]

I had quintuple bypass surgery 17 years ago. I have just had a Nuclear Stress Test which is deemed abnormal. I have an appointment with a cardiologist this Tuesday for consultation and possible cath. Are the PET and the cardiac CT viable alternatives to the cath?

[millerclan]

I am 36 and just had a nuclear stress test today. I was on the treadmill for 14:46 seconds before hitting 162 bpm. The Dr. stated my EKG looked great but then called later and stated the pics showed some abnormalties. I am going in next thursday for discussion of Heart Cath.
Is this the best option? What is probability of good EKG and blockage? Should i do one more test before such an evasive procedure?

[pillytwins]

My mom is 60 y/o with an anbormal "inespecific" EKG and positive stress test whos is been suffering from chest pain for the past year.
After these results her doctor recommended her to have a Cath?
Is this approach correct?
Please help me!

[mar9989]

i suffer from heart palputation went to see the cardiologist i sent me for an echocardiogram and it was normal then he sent me for a stress test and it was abnormal could this mean i have  heart blockage?.....marie

[Ginasouthcarolina]

another alternative to the cath is the cardiac ct scan there is no ventalator involved just a injection of die and they do a 64 slice ct scan of your heart it is a very good test i had it done talk with you doc about that some docs dont do it it is fairly new but i was very happy with it i was able to take my films home and look them over myself...good luck...Gina

[therapist 1]

Can you describe the cardiac catheterisation for me? How do they decide when to stent? What exactly is a stent?
Thank you

[Fionajnz]

If you have a cardiac catheterisation then it helps the cardiologists evaluate whether there is a blockage or not and then to stent it or not, based on what they find.  Thats its purpose in a nutshell.  My 43yo hubby had the same thing happen last wk, he did not totally pass the nuclear stress test and his EKG showed some abnormality that indicated a possible blockage. Three diff cardiologists (we got gold std treatment as our very good friend is a cardiologist) looked at the results and could not say definitively either way.  So they suggested a cath.  He did the catheterisation and it was basically normal - they found a 30% blockage of one of his coronary arteries, but based on his age, profile and strong CAD family hx, they would not stent at this time.  He is now being treated for acid reflux.    

Based on your COPD and pneumonia pre disposition, I would doubt that the Cardiologist would be doing a cath unless he felt you were a good risk, but to be sure in your own mind, you could have a full pulmonary eval with your pulmonologist before the procedure to be sure you are in good shape.

It is generally done as an awake kind of evaluation, using versed as the main sedation drug, plus some lidocaine for numbing the area.  Its a drug that keeps you awake enough to respond and tell them if you feel any pain/discomfort etc and follow directions, but asleep enough that you basically forget what happened.  They do not typically intubate during this procedure so the risk of you being on a respirator is very low, based on a typical cath.

I would go ahead and do the cath in your shoes, it may yield some information that helps you feel much better than you are currently.  

Wishing you well.

Fiona