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stress induced reversible ischemia
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stress induced reversible ischemia


   At age 37, being a female, attending school full time and working full time
  I noticed about a month ago that I was short of breath as I walked across
  campus and sometimes had the feeling of having on a tight turtleneck
  sweater.  After I decided not to chalk this up to stress, I had a Thalluim
  Stress test done.  What showed up was diagnosed as reversible ischemia/
  stressed induced.  What the heck is this?  I drive a school bus and
  have taken a leave of absence  untill I can see the cardioloist which
  will be soon. Any info would be helpful1! Thanks
  
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Dear Jeanie, thank you for your question.  Stress tests are designed to determine if chest discomfort is caused by blockages in the coronary arteries.  The general idea behind a stress test is to determine if exercise can stress the heart enough to identify narrowings in coronary arteries that cause reduced blood flow (ischemia) to areas of the heart muscle.  The heart is a muscle like other muscles in the body and is supplied by three major coronary arteries that supply the muscle with blood (which carries oxygen and nutrients).  During a stress test, a radioisotope (named thallium or sestamibi) is injected at rest and images are obtained of blood flow to the heart muscle.  Then, the same injection and images are obtained just after maximum exercise.  The rest and exercise images are directly compared to determine if an area that has good blood supply at rest has a reduction in blood supply at peak exercise.  If this is found, it is called stress-induced reversible ischemia and generally indicates that a significant coronary artery blockage is present.  However, in 15% of cases, a stress test is either false positive (no blockages are indeed present) or false negative (blockages are present but the stress test fails to identify them).  The gold standard for determining if blockages are indeed present is a test called a cardiac catheterization.  During this procedure, small catheters are inserted into arteries in the groin to inject radioopaque contrast dye into the coronary arteries to directly image them.  If blockages are present, then they will be seen with this method.  You may need a cardiac catheterization to clear up the confusion, but only your cardiologist can decide this.  Generally, it would be unusual for you to have blockages at your age.  
I hope you find this information useful.  Information provided in the heart forum is for general purposes only.  Only your physician can provide specific diagnoses and therapies. Please feel free to write back with additional 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 cardiac problem.





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