Scared...Need these results in English, Please!

[afad]

I recently had a cardiolite stress test (for steady pain/discomfort under left breast) and my MD said the results were "probably normal" and not to worry about it. Since having a mother that had a heart attack at 48yo and open heart surgery at 49, (I'm 37yo and recently had surgery for thyroid cancer), I insisted on seeing a cardiologist. At the appt. with him he said the report looked normal to him. I still have this "discomfort" and am concerned.

Is there anyone who can tell me in English what the following results mean??? On review of raw scintigraphic data, there is a moderate motion artifact at both rest and stress along with a large chest wall attenuation artifact overlying the basolateral and anterior walls at both rest and stress. Review of tomographic slices at rest and stress, and the polar plots reveals two moderate size, moderate intensity perfusion defects in the anteroseptum and anterior wall, and the inferoseptum into the inferoapex. These defects are all more severe at rest than stress and are most likely secondary to variable attenuation artifact. However the moderate motion artifact present at both rest and stress makes it difficult to exclude ischemia with certainty. CONCLUSION: Probably normal cardiolite stress test with atttenuation and motion artifacts as noted.

Thank you!

[CCF-M.D.-KE]

Dear Afad,

This report sounds very confusing. The type stress test you had uses radioactive tracers to determine whether or not there are areas of the heart recieving inadequate blood flow, which is suggestive of blockages in the heart arteries. Your stress test has shown areas of the heart with inadequate blood flow.  However, these findings are not always suggestive of blockages and may be referred to as "motion artifacts" or "attenuation artifacts".  Motion artificts are  related to patient movement during the test which obscures the final result. Attenuation artifact refers to structures , such as the diaphragm and breasts, resulting in blunting of the radioactive signal from the heart, causing an abnormal result.  Your doctors feel as though your study is normal and the artifacts account for the abnormalities seen.
This is very likely the case. However, you could consider repeating the test in order to see if the results are any different. You could also consider having a PET scan done. This is a similar test which results in fewer artifacts. If anything more worrisome emerges from your re-evaluation your doctors may consider performing a heart catheterization, which involves imaging the heart arteries directly to look for blockages.  With this being said, I have not examined you and the doctors who have seen you have a better impression of your clinical situation than I do. I would therefore discuss your concerns with your doctor and ask about the options mentioned above.

Thanks for your question,


CCF-MD-KE

[afad]

Thank you for your reply.  You mention the test has shown areas of my heart with inadequate blood flow.  How can this be corrected?  Is balloon or surgery the only way?  I am meeting with the cardiologist who actually compiled the report on Wednesday and want to go in prepared.  THank you again.

[wailan]

Hi,
    I am 31 and I had a cardiolite stress test my test can out mildly abnormal or equivocal meaning they are not sure if my test was truly abnormal or there was artifact in the way. This really scares me as well I wish there was another way besides a heart catherzation to decide whether it was normal or not. The Dr. here is not doing a pet scan so I have no other way of knowing? confusing isnt it?  BW

[afad]

Have you thought about retaking the test?  I meet with the cardiologist tomorrow and will ask him if he thinks I should retake it.  I would LOVE to do a PET scan.  I wonder if insurance will cover it?    How are you feeling otherwise?  I have this constant pain/discomfort and want it to go away!

[wailan]

Hi,
  I feel ok otherwise. I dont really get chest pain but sometimes get short of breath. I originally started going to the cardiologist because of heart arrythmias I was having for years they got worse after my second child was born. They put me on heart medication which has helped somewhat. Then the dr. suggested a cardiolite stress test just to rule everything out and when he said it came back mildly abnormal or equvicol I freaked out because I expected to have him say that everything was normal. And then he proceeded to say that it could be normal with breast attenuation or abnormal with a scar present which wouldve meant that I had suffered a previous heart attack but he claims that I should wait and see if I get any pain and then if I want I can have a cardiac cath. So meanwhile I am walking on egg shells trying to figure out if I really have something wrong or not. I dont know why they wouldnt do a pet scan it kindof upsets me maybe I will ask if I can repeat the scan I mean it wouldnt hurt. I wish I lived near the cleveland clinic I would go for a second opinion.  Tell me what your dr. says. BW