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What is hypokinesis?
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What is hypokinesis?


  Dear Dr.
  Thank you for responding to my last question two weeks ago.  I need
  your help again.   This again is regarding my husband who had a MI a few
  months ago.  Can you please explain what this diagnosis means.
  This is from the nuclear Thallium 201 test. "large severe defect in the
  territory of the LAD. The apical portion was severe & fixed. The septum
  showed partial reversibility, consistent with ischemia. There appeared to
  be reversible ischemia involving the inferior wall.  The gated spect images
  showed severe global LV systolic dysfunction with particularly severe
  hypokinesis involving the apex, the distal anterior wall and the septum.
  The next day. he had another angiography. Results were:
  Anterolateral -  finding:  Severe hypokinesis
  Apical    - finding: Severe hypokinesis
  I would think the first part of this diagnosis is referring to the damage
  which we knew about.  I'm most concerned about the results from the
  gated spect images and this word "hypokinesis" which I could not find
  on three medical sites.  Thank you, Laura
  
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Dear Laura, thank you for your question. The results of your husband's SPECT Thallium test are consistent with a recent, large anterior wall myocardial infarction.  The nuclear thallium 201 test evaluates perfusion to the heart muscle via the coronary arteries.  From these results, I would conclude that there is "peri-infarct" ischemia around the area of the heart attack in the distribution of the left anterior descending (LAD) artery that supplies the anterior wall and that there may be an additional blockage in the right coronary artery (RCA) that supplies the inferior wall.   Ischemia refers to a reduction in blood flow.  Hypokinesis refers to decreased contractile function of the left ventricle.  After a heart attack, the heart muscle in the distribution of the vessel involved in the heart attack is often hypokinetic due to the damage caused by the heart attack.  However, the contractile function of the heart can sometimes be restored after the initial treatment of a heart attack by treating the blockage(s) with angioplasty or bypass surgery.  From the information you've provided, I suspect that your husband's physicians will want to perform a cardiac catheterization to examine the blockages and make a decision on what form of treatment should be initiated.  
I hope this information is useful. Information provided in the heart forum is for general purposes only.  Only your physician can provided specific diagnoses and therapies.  Feel free to write back with further questions. Good luck!
If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire online by using the Heart Center website at www.ccf.org/heartcenter.   The Heart Center website contains a directory of the cardiology staff that can be used to select the physician best suited to address your




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