What is th description of the test?

[mirwais]

Hello all:


I did Gated SPECT (single photon emission computed tomography)  for my father in lady reading hospital in peshawer and it shows LVEF: 30% EDV: 177ml.  ESV: 124ml.

Impression:      
• large transmural infarct (scar myocardium) involving apex , apical ½ of anterior wall, septum and all other apical segments.
• Marked LV cavity dilatation.
• Myocardial viable territories:
LAD: 1/10 (10%)
LCX: 4/6 (67%)
RCA: 2/4 (50%)


what dose LVEF: 30% mean? and how is my father overall condition?


Thank you in advance

[mentor_86]

sir,
    with this above type of reprort would suggest foe bypass surgery?

[mirwais]

the following is the complete test we have done:

NUCLEAR CARDIOLOGY
DEPARTMENT OF CARDIOLOGY
LADY READING HOSPITAL PESHAWAR

Tc-99m GATED MYOCARDIAL PERFUSION SPECT
(SINGLE PHOTON EMISSION COMPUTED TOMOGRAPHY)

SEX: MALE                                  AGE: 55 Yrs                 Date: 04-03-2011
                                            
¬¬¬¬¬¬¬¬¬
Clinical History:     patient is known case CAD. History of STEMI. Presented with chest pain and SOB on exertion. Echo (27-07-2010) Regional wall motion abnormalities, LV dysfunction (FS-17%). C.Angio (18-02-2011) : LAD: this vessel has Osteal to proximal 20-30% lesion and then totally occluded, RCA: fills LAD retrogradly.

Protocol     REST STUDY PROTOCOL WITH NITRATE FOR VIABILITY

            Procedure     patient was administered sublingual nitroglycerine followed by 25mCi (925  MBq) of Tc-99m MIBI injected intravenously. Gated SPECT imaging was done one hour later.

Gated SPECT  Overall quality of the study is good. There is evidence of marked left ventricular cavity dilatation.
Findings
SPECT images demonstrate absent to severely reduced tracer uptake in apex (anteroapical and inferoapical), anterior (apical and mid), anteroseptal (apical, mid and basal), inferoseptal (apical, mid and basal), apical inferior, apical inferolateral and apical anterolateral segments.
There is moderately reduced tracer uptake in basal anterior and inferior (mid and basal) segments.
Rest of the myocardial segments show good tracer uptake.

GATED IMAGES         Decreased wall thickness in apex, septum, apical ½ of anterior and apical 1/3 of  inferior and lateral walls. Akinesia of apex, septum, apical 1/3 of anterior, inferior and lateral walls. Rest of anterior and inferior walls are hypokinetic.



IMPRESSION:    

• large transmural infarct (scar myocardium) involving apex , apical ½ of    anterior wall, septum and all other apical segments.
•    Marked LV cavity dilatation.
•    Myocardial viable territories:
LAD: 1/10 (10%)
LCX: 4/6 (67%)
RCA: 2/4 (50%)
The doctor administrated the following medicines
1-    PROGREL   -   AP           one tablet per day

2-     NICOGET                       tow tablet per day

3-     LASORIDE    10 mg      one tablet per day

4-    RAST              10 mg      one tablet per day

5-     CORBIS         2.5 mg     one tablet per day

thank you in advance

[kenkeith]

It seems your father has had a heart attack as evidenced by large transmural infarct (scar myocardium) involving apex , apical ½ of anterior wall, septum and all other apical segments.

The heart cells located at the location of the heart attack do not function well enough to pump blood within the normal range (50-70%).  The LVEF of 30% is almost in heart failure range meaning the heart pumps about 30% of the heart's filling capacity.

Your father's left ventricle is enlarged and that will also effect the heart's ability to adequately pump blood into circulation.  The enlargement is expected as the blood received from the lungs and not pumped into circulation within the normal range of 50 to 70% will cause the left ventrical to dilate.

Your father's coronary arteries appear to be no medical problem.  When occlusions exceed 70% it may cause enough blockage to cause chest pains and other symptoms as the heart cells are not receiving sufficient oxygenated blood and can cause heart attack.  The coronary vessels do not appear to be the underlying cause for the medical condition, and not enough information to indicate the medical problem.  Possibilities would be heart muscle disease from viral or bacteria agents, toxicity from medication, alcohol, drugs, medication, etc.

Hope this provides a perspective that will enable you to effectively consult with the treating doctor.  If you have any further questions or comments you are welcome to respond.  Thanks for the question, take care,

Ken