Stress Test Reading

[rossi]

I won’t bore you with why I have to use this board for this but can you please tell me in simple language what these results from a stress nuclear (with the dye stuff) test means and what should I be instructed to do based on these results? You can’t imagine how grateful we are to have you doctors for this.

Nuclear perfusion study findings:

Technical quality of the images is excellent
Perfusion: Abnormal myocardial perfusion study
A moderate sized defect of mild intensity is present in the inferior region(s). Resting images reveal reversibility.
Gated resting E.F. = 65%; E.D.V. = 75ml.
Gated resting wall motion: normal wall motion and normal wall thickening.

Conclusions:

Abnormal myocardial imaging exam
Normal age expected functional aerobic capacity
The heart rate response to exercise was normal
The blood pressure response to exercise was normal
There were frequent PVC’s and PAC’s seen during exercise and recovery. At peak exercise the rhythm might have transiently gone in afib.
There were no clinical symptoms of ischemia reported.
The electrocardiogram during exercise stress was normal.
Nuclear imaging demonstrates ischemia I the inferior wall(s).
Gated SPEC analysis reveals normal wall motion and normal wall thickening. The ejection fraction is 65%.
Discussed results with pt who will observe symptoms and call if symptoms worsen.

[Cleveland Clinic]

The scan showed decreased blood flow in the inferior region, moderately sized and mil din intensity. Given the single location and mild in intensity, one way to manage this ( that is in the patient without worrisome signs or symptoms) is to medically manage the ischemia with medications. It there was more significant ischemia or if there were more worrisome or high risk findings then a more aggressive approach with a diagnostic left heart catheterization could be procured.