Stress test results explanationa

[anjulito]

I'm a 39 year old male 5'7 175 LBS non-smoker. other wise healthy. recently addimited to the hospital with chest pains and dizzzines. I'm concerned as to what brought me to this condition, is there permanent muscle damage? I cannot tell from reading the results.
I have no history of high cholesterol or high blood pressure, also no family history of heart desease.
A stress test was preformed and these are the results.
I was given the following medications and have a follow up appointment on the 22 dec.

Coreg 3.125mg, Zocor 20mg, Spironolactone 25mg, Altace 5 mg
Please explain these as detailed as possible.

PERFUSION: review of the nuclear myocardial perfusion images revealed a reversible perfusion  deficit in the anteroseptal wall and inferior wall. there is a fixed deficit in the apex.

FUNCTION: there is global hypokinesis, worse in the septum and inferior wall.
TID ratio 1.04     Lung /Myocardium count 0.37

Resting Gated
EDV 183ml  ESV 105 ml  SV 78ml
LVEF 42%

Stress Gated
EDV 113ml  ESV 124 ml  SV 67ml
LVEF 35%

IMPRESSION: there is a moderately sized area of mild ischemia in the anteroseptal wall and inferior wall.

I thank you very much for your help in better understanding the result of my test.

Regards,

Julio

[CCF-M.D.-MJM]

Hi Anjulito,

It is hard to know how much weight to put into these results.  Was this an exercise stress test with nuclear imaging?  I know you want to know specifics, but my approach is to be a bit more general.  I think people get lost in details of studies and medications and miss the big picture.

Regarding the results of the nuclear imaging,it appears that year heart pumping function is mildly reduced. If the results are correct, there is muscle damage to your heart.  The question is--can you believe this study?.
  
If I saw you in clinic with these test results, I would order an exercise echocardiogram. First, the exercise portion will give me important information about your level of conditioning. and rank  you against age matched patients so I can compare you to a group of your peers.  The echocardiogram portion will reassess your resting heart function and assess you for ischemia (artery blockages) with exertion.  If there was any question about reduced heart function or ischemia, I would do a cardiac catheterization to assess for artery blockages.

In the mean time, you are a good set of medications.  Hopefully you are taking 81 mg per day of aspirin (unless there is a VERY good reason you can't take aspirin).  Your coreg will be increased slowly, but probably should be increased if your blood pressure allows.

If it were me and I had reduced heart function, I would want to see a cardiologist.  I am not sure if you are dealing an internist or a cardiologist.....but I would prefer a specialist.

I hope this helps answer your questions and I wish you well.

[anjulito]

To answer your question I will be seeing a cardialogist on the 21 Dec. Now, Would cardiac catheterization help determine with some certainty, if there is muscle damage as well as arterial blockage.
Also, if there isn't blockage what could have caused this condition..?
any thoughts.???

[CCF-M.D.-MJM]

A non invasive echocardiogram would help determine if there is muscle damage.  If you heart function is reduced, you will likely need a cardiac catheterization to determine if the cause is coronary artery disease.  If you have no coronary disease, there are several known causes of reduced heart function called a nonischemic cardiomyopathy or dilated cardiomyopathy.  Most commonly it is inherited, often by yet unknown genetic links, other things like abnornal thyroid function and viral infections.

Glad to hear you are seeing a cardiologist.  Happy holidays.