DH (48yo - 5’9” – 230lbs) was in CCU for 4 days following chest pain. Had quite high BP, already on Atenolol 50. CT Angio, EKG, Echo & Doplers were done. They sent him home with a Persantine MIBI to follow in a few days. Also put him on Avapro 300, Norvasc 10 and ASA 81.
These are the results of the MIBI.
Rest Data: HR 60/min BP 110/80 ECG Normal sinus rhythm. Right Bundle Branch Block.
Stress Data: Bruce Protocol Duration 2min 32sec Mets 5.2.
Max HR 91/min (52% target) Max BP 142/90mmHg Reason for Termination Protocol
Radio pharmaceutical injected: 1.0 GBg Tc99-m Sestamibe.
No cardiac dilation with stress.
Perfusion images at peak stress and rest demonstrate a moderate reversible anterior and anteroapical defect.
Normal LV wall motion at rest with an EF of 58%.
Normal LV wall motion 30 minutes post stress with an EF of 52%.
Negative stress ECG but abnormal perfusion images demonstrating reversible ischemia in the territory of the LAD . Normal LV function. The scan may predict high risk given the extent of the defect seen and fall in EF. Clinical correlation required.
Family Dr has put DH off work and he’s not allowed to do anything stressful till seen by the Cardiologist. Waiting and wondering is very stressful!
Our Family Dr is quite concerned as are we. The Cardiologist went away the day of the test and is away for the next 2 weeks. We don't know if we need to find someone else or if we just wait for our appt in 3 weeks from now.
He has an area in the front of his heart that gets low oxygen supply. The muscle is starving for oxygen when he exerts himself, that's why he is to be stress free, mostly with no straneous exercise or exertion. As long as he is not having any chest pain at rest and he is taking a baby ASA and the atenolol, and his BP is well controlled, he can wait for the next 2 weeks. If during that time he experiences any chest pain at all, he should go directly to the ER and let them know his medical history. This also applies if he begins having shortness of breath. Make sure that his BP is well controlled. The good news is that his heart function is still normal and we want to keep it this way. Again, any chest pain, and he is on his way to the ER. He should also have nitroglycerin around to take when chest pain develops. This will most likely be fixed by a catheterization and an intervention to one of the vessels in the heart. Sometimes, depending on what the catheterization shows, open heart surgery is needed. This only happens in about 10% of patients.
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