Stress Test Results Explained

I am a 55 year-old male who had a heart attack in 1997. I had to have triple by pass surgery right after it.  Could you please explain the recent stress test results to me?  The patient exercised for 6 minutes and 53 seconds on the Bruce protocol, achieving 7.0 METS.  He had a non-diagnostic ECG test for ischemia secondary to low heart rate, borderline functional capacity.  The test was stopped secondary to fatigue.  One minute prior to peak exercise the patient received 9.4 mCi of intravenous Cardiolite.  A few hours later the patient received 30.0 mCi of intravenous Cardiolite.  The short axis reveals a dilated left ventricle.  The vertical axis reveals a moderate defect involving the mid anterior wall and inferior wall, without significant redistribution.  The horizontal axis reveals a severe transmural defect involving the anterolateral wall and a transmural defect involving the anterolateral apical wall, with just trace redistribution.  The bull's eye image support the above findings. The LV function is 42% with diffuse global hypokinesis, however, anterolateral apical wall is akinetic.  Overall, there is evidence for a dilated left ventricle with a moerate defect involving the mid anterior, anterolaterwall, transmural defect involving anterolacteral apical wall and a moderate defect involving the inferior wall. At the most there is just race reversibility in the distal anterolateral apical wall, althought there is diffuse global hypokinesis, the anterolateral apical wall in akinetic.

[Cleveland Clinic]

djis,

Stress testing has several parts all of which are predictive for your overall outcome.

1) The actual exercise if you are able to exercise and how your heart rate changes during the procedure.  You exercised but didnt achive a full heart rate to interpret your ecg changes probably due to your medications. Your fuctional capacity is also a measure of how much exercise you were able to perform. You were borderline average for your age. The better your fucntional capacity, the better your overall prognosis.

2) Cardiolite is the radioisotope used to examine which areas of the heart may not be getting enough blood through nuclear imaging.  Using this imagin your ventricle is bigger than normal most likely from damage from your heart attack.  The  transmural defect is the damage from the heart attack also seen with the nuclear imaging as is akinesis of the anterior wall which means the wall doesnt contract well.  Reversibility would mean that some of the tissue from the heart attack is still living and not recieveing blood. The fact that there isnt much reversibility means this area is scar.  

Without any symtoms (symptoms), this test most likely means you had a heart attack with a scar in the front wall of the heart, and there are no other
areas of the heart that are not getting blood. If this is the case, you probably were told to continue your medical therapy with careful attention to continued conditioning (to improve your functional capacity), weight loss, smoking cessation, and blood pressur eand lipid control.

good luck

[Lu G]

I am 83 years old and have just had a stress test.    Iam told "reversible ischemia involving the anterolacteral wall extending into apical region.  Please explain.  Lu G

[Blaz257]

A related discussion, Explain Cardiolite report was started.