understanding medical terminology

1. Normal myocardial perfusion study with moderate size fixed
anterior wall defect with no ischemia. The fixed anterior wall
defect is likely due to soft-tissue attenuation artifact.
2. A moderate size fixed interior wall defect with no ischemia.
The fixed interior wall defect is likely due to soft-tissue
diaphragmatic attenuation artifact.
This was the conclusion after a chemical stress test on 2/25/04.
On 10/1/04, I had a heart attack. Could someone interpret #1.
and #2. for me?

[CCF-M.D.-MJM]

Beemer,

Sorry to hear about your heart attack.  Let me answer the question I think you are asking.....how can I have a negative stress test and still have a heart attack.  Stress tests are good at determining long term prognosis and evaluating the progression of coronary disease.  It is not good at determining who is at greatest risk for a heart attack.  Heart attacks usual result from a crack or fissure in one your heart arteries that leads to the formation of a clot or thrombus.  Stress tests are not good at or intended to diagnose valnerable plaque. We still don't have a test that can do that very well.  high sensitivity CRP  is a marker of systemic inflammation and can hint toward patients at great risk, but we are still looking for the magic bullet.

To answer your question directly,
1. Breast tissue or surface tissue can sometimes interfere with interpretation of a nuclear scan and shows up as a fixed region that appears to have decreased blood flow.  The key is that this region is the same in both resting and stress images.  Ischemia (not enough blood flow) is determined by a new defect on the stress image that isn't present for the rest image.

2. This is the same as above, except now it is the diaphragm or breathing muscle that is interfering with test interpretation.

I hope this helps answer your question and thanks for posting.

[sgil]

I recently took part in a heart study through a local university.  I just recieved results today of the echocardiography.  Two comments that I have questions re: are:  1.)Doppler study demonstrates trivial mitral, pulmonic and tricuspid regurgitation.  The peak aortic outflow velocity is normal at 1.1 msec.  Ejection time is 325millisecond.    The other comment I don't understand is:  2.)The inferior vena cava is flat implying low right atrial pressure.  Can anyone help with these comments?  Thank you.

[sgil]

I recently took part in a heart study through a local university. I just recieved results today of the echocardiography. Two comments that I have questions re: are: 1.)Doppler study demonstrates trivial mitral, pulmonic and tricuspid regurgitation. The peak aortic outflow velocity is normal at 1.1 msec. Ejection time is 325millisecond. The other comment I don't understand is: 2.)The inferior vena cava is flat implying low right atrial pressure. Can anyone help with these comments? Thank you.

[bobbo44]

A related discussion, stress test results was started.