Heart Disease Expert Forum
Nuclear Cardiac Imaging.
About This Forum:

This forum is for questions and support regarding heart issues such as: Angina, Angioplasty, Arrhythmia, Bypass Surgery, Cardiomyopathy, Coronary Artery Disease, Defibrillator, Heart Attack, Heart Disease, High Blood Pressure, Mitral Valve Prolapse, Pacemaker, PAD, Stenosis, Stress Tests.

Font Size:
A
A
A
Background:
Blank
Blank
Blank
This expert forum is not accepting new questions. Please post your question in one of our medical support communities.
Blank Blank

Nuclear Cardiac Imaging.

I have a 46 yo male with no known cardiac risks factors other than stating he may have had hypertension in the past but unsure.  No meds.  Having chest pain and shortness of breath.  EKG in ER was normal, chest xray normal, cardiac enzymes neg.  Referred to us for a nuclear stress test and the patient was put on atenolol, ranexa, and imdur.  However, non compliant with the imdur because of headaches.  A 2 day protocol was used.  The patient walked 11 minutes and reached 13.4 mets.  95% to his target heart rate.  The patient was short of breath and had chest pain.  The Ekg did not really show anything significant.  The nuclear images were negative other than the RV showed up prominently on the stress study.  An echo showed neg but had 3 small leaky valves.  Why would the RV only show up on the Stress imaging.  No lung uptake was seen. NO TID levels increased and no Lung heart ratio increase.  My concern are we overlooking something.  I have some ideas of the cause but I am not for sure if these are correct.  
Avatar_dr_m_tn
In all comers, attaining 13.4 mets places you in a low risk category for cv death/events in the next 5 years. Having a prominent rv should make you think of pulmonary hypertension. I would not be concerned about cv death, and treat his symptoms medically for now. Given his sob you may consider pft testing.
Blank
Continue discussion Blank
Blank
Request an Appointment
MedHelp Health Answers
Blank
Weight Tracker
Weight Tracker
Start Tracking Now
RSS Expert Activity
233488_tn?1310696703
Blank
New Cannabis Article from NORTH Mag...
Jul 20 by John C Hagan III, MD, FACS, FAAOBlank
242532_tn?1269553979
Blank
3 Reasons Why You are Still Binge E...
Jul 14 by Roger Gould, M.D.Blank
242532_tn?1269553979
Blank
Emotional Eating: What Your Closet ...
Jul 09 by Roger Gould, M.D.Blank