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Varying Nuclear Stress Test Results
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Varying Nuclear Stress Test Results

I am 63 year old female. I lead a pretty active life altho I can't say I worry too much about exercise or diet. I have been having nuclear stress tests once a year for the past 3 years by my doctor who found and abnormalty in my EKG the first year. He bought equipment to do these tests around that time.
(1) The first test came back abnormal with this impression: Fixed Apical/Inferoseptal Defect with Prior MI in the LAD or RCA distribution; no stree defect, mild LV enlargement, Inferior/septal hypokinesia, LVEF 56%. I was sent to a cardiologist for a cath which came back with a normal left coronary system and 20% irregularity at the sheperd's crook. Ejection 55%. Risk considered low by the cardiologist.
(2) Year 2 test came back Negative Pharmacologic stress for Ischemia, Normail myocardial perfusion study w/no stress defects, normal LV wall motion and thickening annd normal systolic function - LVEF 59%.
(3) Year 3 came back with a normal cardiac echo taken before the stress test with mild mitral prolapse. Then the stress came back with Negative pharm stress for ischemia, duffuse attenuation artifact on rest images (inferior wall, septum, apex), improved perfusion on stress images with persistent defect at the apex - fixed apical defect consistent with infarct scar, apical akinesia, normal systolic function - LVEF 59%.
My question is - should I be concerned about how much these tests differ - it does not give me a warm fuzzy feeling about the accuracy of the tests? Should I worry about the 20% blockage? Should I even be having these tests every year? I soon have an appt with the cardiologist who did my cath.
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367994_tn?1304957193
Q: My question is - should I be concerned about how much these tests differ - it does not give me a warm fuzzy feeling about the accuracy of the tests? Should I worry about the 20% blockage? Should I even be having these tests every year? I soon have an appt with the cardiologist who did my cath.

>>>>: "Fixed Apical/Inferoseptal Defect with Prior MI in the LAD or RCA distribution" info from your first test. Second test, no mention.  Third test: ....rest images (inferior wall, septum, apex), improved perfusion on stress images with persistent defect at the apex - fixed apical defect consistent with infarct scar, apical akinesia.....It seems the tests (1 and 3) indicate a prior myocardio infraction (heart attack) and heart cell necrosis (not viable).

Your ejection fraction is within the normal range (normal is 50-70%) and indicates your heart's contractility strength has the ability to pump 59% of the heart's filling capacity.  If there is serious infarct damage, the heart's ability to pump would be reduced and the EF would be below normal.

The 3 stress tests indicate no coronary artery blockage. There is mild mitral valve prolapse and that is almost always of no medical significance.  20% irregularity at the sheperd's crook indicates some irregularity in the configuration of segment of a vessel or a structure...I don't know the significance of that condition...need more information

Hope this helps provide a perspective to the results of your tests.  If I have missed something or if you have any further questions or comments you are invited to respond. Thanks for sharing, take care

Ken

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Followup and thanks for your reply:
Had a good report after seeing cardiologist this morning. Low risk, no new cath but should get stress tests for next couple years.
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367994_tn?1304957193
Thanks for your response, and I wish you well going forward.

Ken
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