Fixed Anterior Wall Defect - ?

[butterscotch23]

Hi - I just had a nuclear medicine stress test done and the findings revealed a "fixed anterior wall defect which may relate to tissue attenuation artifact. No inducible ischemia appreciated." Gated imagining reveals LV injection fraction of 65%, and my blood pressure started at 134/70 and went to 160/100 after walking about 6 minutes on the treadmill. Infrequent ectopy noted; diagnostic EC changes did not occur. Based on this medical jargon, can anybody out there tell me what this means? If this all sounds ok or standard, then I don't want to incur the cost of going to the cardiologist for a follow-up. Any suggestions? Thanks!

[kenkeith]

The wall defect is considered to be electrical or chemically phenomonon affecting the EKG functionality producing an abnormal result unrelated to the individual tested (artefact).  Has no significance and wall defect is not support by other evidence nor clinical analysis.

No inducible ischemia indicates the test did not produce partially blocked vessels.

EF is good...indicates heart is pumping effectively.  Normal is 50-70% and that is the amount of blood pumped into circulation with each heart beat.

Blood pressure was marginally high.  The doctor would evaluate the metric based on other clinical evidence.  

Ectopy are extra heartbeats...almost everyone experiences that event and not considered significant for any problem.  No eccentric contractions changes noted.

[fizzixgal]

In a nuclear stress test, the images are produced by radiation from a radioactive isotope that you are injected with and which is taken up by the heart muscle. The pictures are taken by a gamma camera that detects and resolves the radiation signal coming from the heart. Less signal from an area of the myocardium is supposed to indicate limitation of perfusion (blood supply), usually due to a blockage. But the radiation has to pass through body tissue to reach the camera. Attenuation artifact means a loss of signal due to absorption by body tissue (bone or soft tissue) and is not due to a blockage. Anterior wall artifacts are extremely common in women because of attenuation by breast tissue. A "fixed" perfusion defect is one that is seen both at rest and post-stress. If real, it can indicate scar tissue, but an apparent fixed anterior wall defect in a woman with no MI history is often (usually?) an attenuation artifact, especially if it is mild. The fact that you had no clinical evidence of ischemia (EKG and/or BP changes showing that your heart muscle wasn't getting enough oxygen) would be supporting evidence that the "defect" was an artifact.

Best to follow up with your cardiologist though -- what the radiologist is saying is that (s)he suspects your test was a false positive but isn't sure. Your doctor might want a follow-up echo or other test to be sure that everything is okay.

[fizzixgal]

By the way, I've just been going through something like this... what they found, on my stress test, was a "reversible" defect, which is one that they only see in the post-exercise scan. Mine was also in the anterior wall, and my cardiologist said it was probably an artifact. It's a little harder (for me, anyway) to understand how a reversible defect could be an attenuation artifact, but today I saw a second cardiologist who settled the question (to his and my satisfaction, anyhow) with a stress echocardiogram, done in his office. I've never been so relieved in my life! I had been stressing over this for two months! So don't worry about it, it probably is an artifact because that is very common, but do follow up for your heart's sake and your peace of mind.

[annbez]

I am scheduled for an anterior cervical fusion of the c 5/6 6/7 on the 26th of June. I am100 % confident in my surgeon, but after my cariac clearance, I am almost ready to call off the surgery. he put me at a moderate risk for basically all the things that can go wrong and now I do not know if it is worth the risk. I have spinal cord compression which is progressing rapidly so I am in a catch 22. Any advise would be appreciated.