Please advice me about

[mirwais]

Dear dr:

The following is the complet test we have done for my father, so please advice about my father overall condition and taking care of him.



                                                NUCLEAR CARDIOLOGY
                                             DEPARTMENT OF CARDIOLOGY
                                        LADY READING HOSPITAL PESHAWAR

                                    Tc-99m GATED MYOCARDIAL PERFUSION SPECT
                              (SINGLE PHOTON EMISSION COMPUTED TOMOGRAPHY)

                         SEX: MALE                                  AGE: 55 Yrs                 Date: 04-03-2011
________________________________________________________________________________________________
                                            
Clinical History:     patient is known case CAD. History of STEMI. Presented with chest pain and SOB on exertion. Echo (27-07-2010) Regional wall motion abnormalities, LV dysfunction (FS-17%). C.Angio (18-02-2011) : LAD: this vessel has Osteal to proximal 20-30% lesion and then totally occluded, RCA: fills LAD retrogradly.
________________________________________________________________________________________________

Protocol     REST STUDY PROTOCOL WITH NITRATE FOR VIABILITY

Procedure     patient was administered sublingual nitroglycerine followed by 25mCi (925  MBq) of Tc-99m
                    MIBI injected intravenously. Gated SPECT imaging was done one hour later.
Findings
                   Gated SPECT  Overall quality of the study is good. There is evidence of marked left ventricular cavity    
                    dilatation.
                   SPECT images demonstrate absent to severely reduced tracer uptake in apex (anteroapical and      
                   inferoapical), anterior (apical and mid), anteroseptal (apical, mid and basal), inferoseptal (apical, mid and
                    basal), apical inferior, apical inferolateral and apical anterolateral segments.
                  There is moderately reduced tracer uptake in basal anterior and inferior (mid and basal) segments.
                   Rest of the myocardial segments show good tracer uptake.

GATED IMAGES         Decreased wall thickness in apex, septum, apical ½ of anterior and apical 1/3 of  inferior and  
                                  lateral walls. Akinesia of apex, septum, apical 1/3 of anterior, inferior and lateral walls. Rest of
                                  anterior and inferior walls are hypokinetic.
                                  LVEF: 30% EDV: 177ml.  ESV: 124ml.


IMPRESSION:    

• large transmural infarct (scar myocardium) involving apex , apical ½ of    anterior wall, septum and all
                  other apical segments.
•    Marked LV cavity dilatation.
•    Myocardial viable territories:
                   LAD: 1/10 (10%)
                   LCX: 4/6 (67%)
                   RCA: 2/4 (50%)



The doctor administrated the following medicines

1-    PROGREL   -   AP           one tablet per day

2-     NICOGET                       tow tablet per day

3-     LASORIDE    10 mg      one tablet per day

4-    RAST              10 mg      one tablet per day

5-     CORBIS         2.5 mg     one tablet per day

thaks in advance.

[kenkeith]

I don't have any comment on your medication except don't rely on any information other than your father's doctor..  The doctor will have a complete medical history, other medical issues, etc.

Q:"large transmural infarct (scar myocardium) involving apex , apical ½ of    anterior wall, septum and all  other apical segments.
•    Marked LV cavity dilatation.
•    Myocardial viable territories:
                   LAD: 1/10 (10%)
                   LCX: 4/6 (67%)
                   RCA: 2/4 (50%)
  LVEF: 30% EDV: 177ml.  ESV: 124ml."


>>>>>>Your father has had a prior heart attack and his heart only pumps about 30% of the blood received from the lungs (normal is 50 to 70% LVEF).  This conditon can cause chest pain, shortness of breath, etc.  The left ventrical is pumping less than normal because of damaged heart wall cells from a prior heart attack.      "Hypokinesis" are heart cells that are alve but existing on low oxygen (can be revitalized with good oxygen/blood) flow)  and the "akinesis" comment on your post is cell negrosis (dead) and the result of scar tissue..
"
The left coronay vesse (LAD) l has some blockage but not of any medical significance.  
The LCX: 4/6 may be a problem at  (67%) due to occlusion, etc.
The RCA is the right side coronary artery at 50% blockage and may be a medical problem.

Hope this helps, and if you have any further questions or comments you are welcome to respond. Thanks for the question, take care, and I wish your father well going forward.  

Ken

[vienna13]

Hi,

No doctors here, but you can see doctors  on the  “related expert forums”  
……just roll down about the middle of the page  and right side it is,  click on the ‘heart disease’.

Take care