Left-side pumping chamber (ventricle) is enlarged, and coronary reversible perfusion defect (no significance). Myocardial perfusion abnormalities occur commonly among patients with HCM, hypercardiomyopathy (dilated LV) HCM. Fixed or only partially reversible defects suggestive of myocardial scar and/or severe ischemia occur primarily in patients with impaired systolic performance. Completely reversible perfusion abnormalities occur predominantly in patients with normal or supranormal left ventricular systolic function (Normal is 55-75% ejection fraction or
REPORT: This is a Bruce protocol stress Cardiolite. The patient
exercised for a total of eleven (11) minutes and thirty (30) seconds of
a Bruce protocol with a peak heart rate of 161bpm., and a peak blood
pressure of 186/100, this is 88% of the predicted maximum heart rate.
There was no diagnostic E K G changes at peak stress. There was no
chest discomfort. 12 mCi of Cardiolite were infused at rest and 35 mCi
at stress and images were obtained in SPECT configuration at rest and
stress and these images revealed a dilated left ventricle with no
significant reversible uptake at rest and stress. The Gated portion
demonstrates modest reduction in L V systolic function with an ejection
fraction of 43%.
CONCLUSIONS: Abnormal Bruce protocol stress Cardioli'te with no
significant reversible ischemia, but with a dilated left ventricle and
modest reduction in L V systolic function as described above
how bad is this im 38 year old 175lb male smoker
For an insight from A diferrent perspective. Perfusion imaging may be done before and at the end of the exercise stress test to compare the images at rest and images that may change due to stressing the heart. Comparing these images of the heart before and after the stress test helps to show if ischemia is reversible. “Reversible” ischemia on imaging means the imaging portion of the stress test had a change in appearance from before and after the stress test indicating stress induced ischemia.
Imaging studies may show ischemia before and after the stress test, but if it does not change, then that ischemia may be due to a scar on the heart from a prior heart attack.
An ejection fraction (EF) is compensatory mechanism by dilating the left ventricle to increase cardiac output. But if the LV dilates more than normal range, the EF will decrease and if the underlying cause for the dilated LV. And/or reduced EF can be due to scar tissue that effects wall movement and that impairs normal EF.
Your EF is slightly less than normal so if there is scar tissue from a previous heart attack the damage is slight.
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