heart problems

[Barb1892]

I have a family history of heart diease and just had a nuclear stress test with some bad results. I am scheduled for a heart cath on the 8th. The problems it says in the report can be reversed with ischemia. What does this mean, and what does reduced radiotracer activity mean?

[kenkeith]

From another perspective, NON REVERSIBLE ischemia (lack of blood flow) indicates hypoperfusion (decreased blood flow) at REST or without STRESS (exercise, etc.) there is inufficient blood flow to heart cells..  

Insufficient blood supply to the myocardium can result in myocardial ischemia, injury or infarction (cell necrosis...death).  For a long time, it was thought that decreased blood flow caused necrosis of heart cells. Now there is a diagnostic distinction between myocardial infarction and ischemia—which is usually not possible from clinical or EKG findings alone—has taken on significant therapeutic and economic implications, given the development of new therapies.  There may have been EKG with your stress test, and the test showed ST segment elevated with a Q or without a Q wave.  Reguires further testing because an EKG is not a very good source for conditions other rhythm disorders, and there may have been a perfusion test for any occlusions.  

I had an ischemic heart attack several years ago, and tests showed hypokinesis (heart wall movement impairment) and at one time it would be assumed the heart cells were dead...in fact at the time that seemed to be the prevailing wisdom.  However, with medication and a stent the blood supply was increased to the deficit area.  The heart cells were revitalized and returned to normal functionality...that would be reversable ischemia. For more information google "heart cell hibernation".

Thanks for sharing, and if you have any followup questions your are welcome to respond. Take care.

[ed34]

The scan you had shows how well the blood is being distributed through your heart tissue. Reversable Ischaemia means that there is a supply of blood to a given area of heart tissue, but not enough, so the tissue is underfed oxygen. If normal blood flow is resumed, this tissue will recover over some time. So, they will do an angiogram to determine where the blockage/s is/are and IF stents can be used to improve the situation. If the picture looks too difficult for stenting, such as there being too much disease, then bypass surgery will be the preferred option.