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Please explain the findings on Dual Isotope Stress Test.
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Please explain the findings on Dual Isotope Stress Test.

Could you help me understand my stress test findings?  I am scheduled for a heart catherization due to these findings.
I'm am a 45 year old female with obesity and Graves Disease.  
Exercised for 6 minutes and 30 seconds of a Bruce Protocol.  Heart rate increased to 151 which was 86% of her perdicted maximal heart rate.  Blood pressure was 124/92 at baseline and peaked at 160/78.  Had slight chest discomfort during exercise which resolved with rest.  The electrocardiogram is equivocal for ischemia at 0.5 mm of up sloping ST depression in the inferolateral leads.  The nuclear cardiac perfusion scan is pending.
1.  Adequate exercise tolerance for the patient's age and condition.
2.  Exercise treadmill test is equivocal for ischemia at 86% of her predicted maximal heart rate.
3.  Normal hemodynamic response to exercise.
4.  Stress test is positive for chest discomfort of uncertain etiology.
5.  Please correlate with stress myocardial perfusion scan.

The patient was injected  with 3.3 mCi of Thallium Chloride and resting images were obtained.  Subsequently, the patient exercised on the Bruce protocol for 6 minutes and 30 seconds.  At peak exercise the patient waws injected with 29 mCI of Technetium Sestamibi and stress images were obtained.  Subsequently, tomographic inaging with gated acquisition was obtained.

Findings.:  Anteroapical wall - There is a small sized areal of mild intensity defect which was partially reversible.  Lateral wall - normal.  Septal wall - normal.  Inferior wall- normal.  Gated Spect imaging showed normal left ventricular size with an ejection fraction of 70 %.

1.   Abnormal myocardial perfusion study with a partially reversible defect in the anteroapical segment.
2.  Normal LV size with an ejection fraction of 70 %.

What does this mean?  Do I have a blockage?  Does this warrant a heart cath?  I'm still having chest pains and discomfort.  Not sure where these pains are coming from.  Please help.

Thank you!
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367994_tn?1304957193
QUOTE: "Had slight chest discomfort during exercise which resolved with rest.  The electrocardiogram is equivocal for ischemia at 0.5 mm of up sloping ST depression in the inferolateral leads".

The EKG reading indicates there is a possibility of a partially blocked vessel and the slight chest discomfort during the test.  Everything else appears to be normal, but there may be a slight impairment to blood flow in the anteropical segment.  If the chest pain is related to the heart (I assume other causes have been ruled out), a cath would be the proper protocol for a diagnosis.
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