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Interpreting Stress Test Results
Hello, all:

I'm a 39 year old woman who'd been experiencing palpitations. Upon my GP's recommendation, I went to a cardiologist who performed an EKG stress test and a Nuclear scan on my heart. The latter was conducted because my EKG stress test gave the cardiologist concern that I might have either a blockage or a cracked artery.

Fortunately, the nuclear scan revealed that I didn't have any blockages or artery damage. My cardiologist told me that my heart rate was irregular and that my palpitations may be the result of hormonal changes.

However, when I got a copy of my stress test results, it said the following:

EKG stress test: horizontal ST depression
Nuclear scan: stress images reveal moderate in size, moderate in intensity anterior defect
Rest scan shows: no changes
Motion scan shows: normal contractility and thickening of the walls EF 68%

Final Interpretation: moderate in size and intensity fixed anterior defect consistent with breast attenuation.

Firstly, I have no idea what any of that means. Can anyone here explain it to me?

Secondly, if I have a heart defect, why on earth wouldn't my cardiologist tell me of these findings? Isn't that kind of significant?

Any insight offered would be greatly appreciated!
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Call your Dr and ask him/her to explain the findings for sure, but my understanding is that "breast attenuation" simply means the breast tissue produces an artifact (false change) in the images - so essentially interference from the breast tissue creates a false positive -- apprently by shifting the patient's position, the pictures can be made clear and the anomaly disappears but in the case of a nuke stress test you can shift the patient's position.  Additionally, your motion scan shows that your contractility and ejection fraction are great so your Dr. is probably using that as the confirmation that there is indeed nothing wrogn with your heart and that the defect seen is just an artifact due to the tissue interference.  

As far as the horizontal ST segment chanegs seen during the stress test, you'll have to ask your Dr.  There are standard explanations for horizontal ST segment changes and you can google them if you like but it sounds like your Dr is satisfied that its a benign irregularity in your case - go ahead and ask though, it'll give you piece of mind.  Either way, the ejection fraction and contractility results are very good news.  Best of luck.
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