Tetrofosmnin Treadmill Stress Test

[jdub157]

I am 37 year old male with no family heart issues (early in life before 70).  I have mitral valve prolapse and was on a normal check up when this test was requested.  I have also been diagnosed with a mild case of sleep apnea (don't know if this has any effect).  I went through a Tetrofosmnin Treadmill Stress Test with the conclusion resuling in an abnormal or positive test.  The findings are as follows:

Spect Images:  There is a partially reversible medium sized moderate defect in the inferior wall.

Left Ventricular Size:  The left Ventricle is mildly dilated

Gated Spect Images:  The overall left Ventricular systolic function is mildly depressed with an ejection fraction of 43%.  There is moderate hypokinesia in the inferior wall.

Conclusion:
1. The study is abnormal
2. There is a medium sized probable non-transmural mycardial infarction in the distribution of the right coronary artery or left circumflex coronary artery and moderate peri-infarct ischemia.
3. The left ventricular systolic function is mildly depressed.

Blood pressure lying down 124/70  54bpm; standing 120/74  58bpm; During the test 130/80 112bpm - 140/80  120bpm - 170/80  132 bpm (9 minutes passed to this point).  Test completed at 12 minutes.

I had no problems completing the test: no pains, no significant ST changes, resting ECG reveals no significant abnormality, and adequate blood pressure response.  Overall impression was that I had good exercise capacity, tradmill negative for angina, negative for ischemic ST changes.

I need this explained in simpler terms.  If the findings are not good, should I have a second opinion.  The doctor was somewhat vague and recomended additional testing.  Looking for helpful suggestions or alternatives.  Need to be sure that I make the right decissions to move forward.  If a second opinion is warranted; what kind of test is advisable?

Jdub

[jdub157]

What should be asked for in the second opinion?  Should another thallium test be performed?  Would a negative negate the previous positive?  I have talked with two additional cardiologists and get different opinions of the direction to proceed.  One indicates that I am young and should aggressively proceed to eliminate any doubt and the other believes another test may be warranted.   I need to make some decisions soon on the direction to proceed, so any advice is helpful.

Regards,

Jdub

[erijon]

I think I would want a second opinion. What they are basically telling you is that you have had a heart attack which is backed up by your dialated LV and low EF of 43%, it should be over 50%. This means your LV, the main pumping chamber, is not working as it should. I don't think these results are very clear and I would be looking for  second opinion fairly quickly.

Good Luck!

Tony