STRESS TEST RESULTS

[SDB1]

MY 62 YR OLD BROTHER JUST HAD THE FOLLOWING FINDINGS ON HIS STRESS TEST:
THERE WAS AN ANTEROLATERAL PERFUSION DEFECT ON STRESS IMAGES THAT WAS PARTIALLY REVERSABLE ON THE REST IMAGES. THERE WERE NO SUSPECTED ARTIFACTS NMOTED. REGIONAL WALL MOTION AND THICKENING WAS ABNORMAL.
IMPRESSION: MILD TO MODERATELY ABNORMAL MYOCARDIAL PERFUSION TETROFOS,IN SPECT IOMAGING AFTER PERSANTINE INFUSION SHOWING AN AREA OF FIXED DEFECT IN THE SEPTAL WALL WITH EVIDENCE OF ISCHEMIA IN THE ANTEROLATERAL WALL OF THE MYOCARDIUM.

DO THESE FINDING SUGGEST AN ANGIOGRAM? COULD YOU EXPLAIN THIS TO ME IN MORE LAYMAN TERMS? ALSO, IS THIS CONSIDERED AN EMERGENCY, OR WOULD HE HAVE TIME TO GET A SECOND OPINION, OR SHOULD HE GO RIGHT FOR THE ANGIOGRAM? THANK YOU.

[CCF-M.D.-MJM]

Hello SDB1,

Very good question.  If you ask this question to 10 cardiologists you are likely to have 2 answers at about equal rates. It also depends on if you ask an interventional cardiologist or a prevention or general cardiologist.

The first question I would ask is "why was the test ordered?"

If the test was ordered for symptoms of angina, unexplained heart failure symptoms or something like that, a positive stress test would lead me to order and angiogram.  If the test was ordered in an asymptomatic person, I would maximize medical management to control blood pressure and decrease lipids.

The reality is that no study has shown that stenting increases survival, but it does improve symptoms.  Therefore, if symptoms are present, I would order the cath.  If symptoms are not present, I would treat medical and only act if symptoms present.  Not everyone would agree with this, but I think this closely represents the American College of Cardiology guidelines.

It is only an emergency if he has increasing symptoms or if he is having a heart attack.  If he wants a second opinion and is not having increasing symptoms or a heart attack, he probably has time.

The laymans explanation of the stress test results suggest that he has had a heart attack before and that he has another area that has a significant blockage, but the tissue is still living.

I hope this helps answer your questions.  Good luck.

[quiltlover]

I had a similar experience in June.  My cardiologist found what may or may not be a blockage septally(?whatever that means.) But, because he feels that catheterization is more risky than the small blockage he won't recommend doing one.  He does however want to do another stress test next June. Meanwhile I see him again in December and keep to my medication regimine.

Hope all goes well with you.
Jan

[Billie Gene]

Hello,

I wanted a Dr's advise.  I am a 33 year old woman.
I had a stress test done because I went to the
hospital myself. I had heart pain not chest, but heart pain with dizzyness and my left hand going weak and my heart
racing really fast and hot and cold feeling.

The hospital admitted me. I just got out today.  The doctors were schocked because my heart did the stress test. When I
sat down I was ok when I got uo my heart went to 164.

They said I have hypotension (low blood presure). They put me on medication yesterday.  I feel ok, but some times I still have the heart pain like if someone is puting a needle in my heart it comes and goes.  Why am I getting that pain? Is that a sign of heart attack down the road or is it that my heart was racing for a while about 2 months that the mussles are sore or could it be mussles that are stressed.  What could it be? Will it go away.

My heart doctor is running more test on me. I forget why he told me about the pain.  I like to hear other opinnions.  Because this has been going on for 2 months and I went to 3 doctors they all told me stress, but the way the heart was racing and the pain and getting hot and cold  I new it wasn't stress, so I took myself to the hospital and found out myself.  I do have a good heart doctor though, but I would like to know more on the heart pain.


Thanks so much,
Billie Gene

[Joan337]

A related discussion, wait times after stress test was started.