Nuclears stress test results back need help with the results!!

[marcmega]

Hello people my  nuclear stress test result results came back 9/16/09.....Im still having some chest pain and palpitatons but can someone interpret these results for me..dr. jason or cardiostar thanks!

Myocardial perfusion spect imaging revealed no eveidence of inducible myocardila ischemia. or left infraction.(what does that mean)?
Left ventricular global function at rest was normal....(please explain)
Ejection fraction of 68% (whats the signifcance if this number?)
Gated wall motion revealed normal motion and thickening of all myocardial segments(what are the segments and isnt thickening bad)?
Left venticular transient cavity dialtion was not observeed...?
There was no adnormal ling uptake?

Thanks I would appreciated some incite on what this means!

[erijon]

marc,

The most imortant thing to kow is that everthing listed is NORMAL, congrats! The things to key on is the EF of 68%, excellent number, should be between 50 - 75% and means your heart is working very efficiently.Also, no dialation was found which means everything is the correct size and there was normal wall motion which means that your heart muscle is contracting as it should. Also, the fact that there was no evidence of inducible ischemia means that all of your heart is getting good blood flow so your arteries are clear. Overall an excellent report.

Again, congrats!

Jon

[erijon]

FYI, cardiostar is on WedMD............. (also a great site).

[cblmn7]

thats a excellent report there is many of us on here that would love that report.erijon explained pretty much everything. good going the key words were no evidence of and normal. Congrats

[marcmega]

thanks guys i just worry because i still get chest pain from time to time!but i can assume its not my heart!and guys how dead on is this test would it show blockage?

[ed34]

I always feel like the party pooper Marcmega but things are not as straight cut as people are saying. The test you have just had does give you one very relieving and happy piece of information, you have no tissue damage in your heart. However, it does not mean there isn't a blockage forming and causing you to have angina. What it does mean is that although you are experiencing discomfort, your heart is receiving SOME oxygen to keep the tissue alive. The next step is to establish if your symptoms can be controlled through medication. If like me you would rather know what the condition of your arteries are, then you will have to press for an angiogram. The worrying part of your analysis is over, with no tissue damage the Cardiologists can work out the best procedure for relieving your symptoms and return you to a normal quality of life.

[marcmega]

I want to ask the pain ive been experiencing is not angina like its in the upper right side of the chest cutting and sharp then goes away and comes back ...in the pectoral area ..any ideas!!!Thanks ed!

[erijon]

marc,

The normal nuclear stress test means your arteries are clear. Your chest pain does not sound cardiac in nature at all. Sharp, short pains that come and go are not typical of heart disease, this is more likely a muscular issue. Her are some guidelines;

Atypical Chest Pain Not Suggestive of Coronary Heart Disease (CHD)

Appears also at rest
Exercise tolerance is good despite pain
Continues for hours or days
Is associated with breathing or chest wall movements
Is sharp in character
Is displaced laterally towards the apex
May be felt on palpation
Is experienced as palpitations or occasional ectopic beats
Is felt in the upper abdominal region or below the left costal arch
Is not relieved with glyceryl trinitrate within a few minutes


Bottom line, you could keep second guessing the results, but a normal nuclear stress test gives you a very excellent prognosis. If you do keep pushing for more tests, you will be risking a false positive test which would lead to more invasive tests which given your symptoms just don't sound necessary. Are there exceptions, yes but a normal nuclear stress tests is accurate in your case 93% of the time. Overall I would be very happy with your report!

Enjoy life now!

Jon

[ed34]

"The normal nuclear stress test means your arteries are clear"

That's what all the little hospital booklets tell you, but not what a good cardiologist will tell you. There have been too many instances where scans do not reflect what is shown in an angiogram and so good cardiologists only use the results of these scans to reveal any dead areas. Three top heart hospitals in the UK have seen my angiograms and nuclear results and every cardiologist said they only use nuclear scan results to establish what damage has occurred. They can see whether blood is feeding all the areas, but whether it is receiving enough blood is not clear. To try and establish this by the amount of 'glow' on the image has been proven too inaccurate. To know you have blood to all areas is a brilliant start, which is what I said. I too would be happy with that result. Collaterals can also give a false reading, where blood looks to be in abundance due to so many tiny vessels feeding the tissue, but there is little volume. Not enough for high exertion.
In this report the chambers are in good shape and the heart is functioning very well ejecting a good volume of blood. When a set of results are good like this but other symptoms persist, then obviously it is wise to explore other avenues. I said it COULD be angina and this is very obvious. However, if your pains come when you are resting, then they are unlikely to be related to the heart. If they appear on exertion and quickly stop when you relax, then it is likely to be heart related.

[erijon]

Hard to believe, look marc, you can go one of two ways here. Take the word of your doctors, individuals that went to college and got a degree in pre-med, graduated from medical school, did a 4 year residency and another 2 plus years of a fellowship in a specialty like cardiology, have operated on human hearts and healed them or you can go with a guy from the Internet who is none of the things stated above, go with the common thought process in the UK, keep being worried, have every test under the sun and wait until one comes back positive so they have a reason to do a cath. Every point ed makes is true, there COULD be collaterals that affect the test. There could also be thousands of other things that COULD be an issue, there are no 100% guarantees outside of a cath or open heart surgery.

If your nuclear stress test is clean, you have a good tolerance for exercise and your symptoms are atypical of heart disease, I would be a very happy camper if I were you. As I told you in a previous email, there will ALWAYS be more people posting that had unusual situations, it's just the nature of forums like this. I'm not minimizing what the previous poster went through, it was his reality, but it does not always equate to yours. You have to look at things as if the glass is half full or half empty, the later will make you miserable and cynical of the medical profession as a whole.

Good luck, reach out to me if I can help.

Jon

[erijon]

marc,

Also remember what Dr. Beckman told you on the other web site (yes, I am a member of that group), everything was great! I know how much you respect him by your posts, why would you doubt him? He is a VERY good doctor.

[erijon]

Sorry, spelled his name wrong! That should be Dr. Beckerman, I've done that to him many times..... Yes, you and I have traded posts many times on that other site with my other screen name, I feel like I know you!

[erijon]

ed, I stated that everything you said was true, just gave an alternate point of view. I would be happy to discuss it off the forum.

[marcmega]

I really appreciate you guys help.My cardio spec released me from care and im now seeing a psych doctor..who has me on xanax...i just get these annoying  chest issues and its very trouble some i dont want a cath that could damage my heart are create more issues ...i walked 2  miles today in the park with no chest pain so again i just want to get this over with...thanks!!

[erijon]

Hang in there marc, I bet you'll do great. Exercise is a great way to measure your progress so keep pushing yourself within any limits your doctor gave you.