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want to understand this

EXERCISE MYOVIEW SPECT MYOCARDIAL PERFSUION STUDY
AGE: 30 Years
INDICATION: IHD , to see reversible ischemia/viability
Isotope: 07 mCi of Tc-99m myoview at peak stress
              21 mCi of Tc-99m myoview at rest, 10 minutes after s/l nitrate (viability protocol)

Stress Test: Patient was exercised for 10.20 min reaching 4th stage of Bruce Protocol.
Pulse rate rose from 90/min to 191/min and BP from 120/90 mm Hg to 160/100 mm Hg.
Exercised was stopped due to dyspena and fatigue. His resting ECG revealed old inferio wall
mi. 1mm up sloping ST depressions were noted in inferolateral leads at peak stress, which
Reverted to baseline in the early recovery period. Maximal exercise, negative test with good
effort tolerance. Hypertensive response to exercise is noted.
SPECT images were acquired around an arc of 180 (RAO- LPO)
Scan Interpretation: scan shows medium sized fixed perfusion defect of moderate severity
Involve mid-cavity to basal inferolateral wall. There is no evidence of inducible ischemia/
Viability LV myocardium is normally perfused.
LV cavity is normal sized.
Conclusion:
Exercise myocardial SPECT study at 100% predicted HR and 10.9 METS is negative for inducible
Ischemia/viability
There is evidence of medium sized fixed perfusion defect of moderate severity involving mid-cavity to basal inferolateral wall.


Interpretation:
Cardiac chambers are of normal size
There is no left ventricular hypertrophy.
Left ventricular systolic function is moderately reduced.
Visually estimated ejection fraction is approximately 35-40%.
Inferioposterior wall and lateral segments are kinetic, inferior IVS hypo kinetic, Rest are contracting normal.
Right ventricular systolic function is normal.
Mitral valve thickened, with no stenosis. Moderate mitral regurgitation is noted with vena contracta 0.6 mm, ERO 0.3 cmsq and regurgitation fraction 42%
Tricuspid valve normal with no stenosis. Moderate tricuspid regurgitation, peak pressure gradient of 40 mm Hg.
Rest of the valves is normal in morphology with no stenosis and no regurgitation.
Estimated pulmonary artery systolic pressure is approximately 50 mmHg.
Normal transmitral inflow pattern. Normal pulmonary vein Doppler.
E/E’ is 7, suggestive of normal LV filling pressure.
No obvious thrombus, vegetation, pericardial effusion or intracardiac shunt.

Conclusion:
Cardiac chambers are of normal size.
Moderately reduced left ventricular systolic function.
Moderate mitral regurgitation.
Moderate tricuspid regurgitation.
Moderate pulmonary artery hypertension.
10 Responses
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Avatar universal
Ken

it is really apreciating that u replied alot ..................... Bro Live long and healthy life ............. ALLAH give you and me strenght (Ameen)
Helpful - 0
367994 tn?1304953593
American Heart Organization: "Atherosclerosis (buildup of fatty substances in the arteries) is a chief contributor to the high number of deaths from smoking. Many studies detail the evidence that cigarette smoking is a major cause of coronary heart disease, which leads to heart attack".

>>>It could have contributed to your perfusion defect of coronary vessel and other vessels as well.

An angiogram provides a better evaluation of your coronary vessels and that can be an interventional process with a cath or non-interventional images with MRI or CT scan.  If you and your doctor decide a stent implant is the only option to eliminate sympoms then an cath angiogram, if you and your doctor want a better evaluation of your coronary anatomy that includes the entire anatomy of the vessel including plaque buildup within the layers of the vessel, etc. then the non- interventional procedure MRI or CT scan angiogram may be the option.

Or you and your doctor jhave all the information necessary based on the tests, there is no need to go any further other than treatment of the known occlusion detected by previous tests. The treatment would be medication to dilate vessels and/or stent to provide a better blood flow to specific deficit of good blood supply.

Ken

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Avatar universal
i m also want to go on Angiography......................wat u suggest?
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Avatar universal
Thanks for ur support

One more thing want to tellu that i m a smoker just.
Helpful - 0
367994 tn?1304953593
Q: Doc Said my one Artry is blocked and heart is also demmaged bcz of that blockage...........................what u think and recomend...........waiting

>>>Consistent with that finding is hypokinesis (impaired wall movement)  and fixed perfusion defect (blockage). The blockage impeded a good flow of blood to heart cells and the cells may be damaged (necrotic) or viable but not funcitioning effectively and that condition is referred to heart cell hibernation.  I experienced an almost similar condiiton seven years ago...my hypokinetic heart wall caused an EF below 29% and heart failure.  Treatment revitalized the hibernating heart cells by providing a better blood flow to the  oxygenated deprived cells.  Treatment was a stent and medication that dilated the vessels
enabling better blood flow.

Hope this helps.  Take care,

Ken
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Avatar universal
Echo Report

Interpretation:
Cardiac chambers are of normal size
There is no left ventricular hypertrophy.
Left ventricular systolic function is moderately reduced.
Visually estimated ejection fraction is approximately 35-40%.
Inferioposterior wall and lateral segments are kinetic, inferior IVS hypo kinetic, Rest are contracting normal.
Right ventricular systolic function is normal.
Mitral valve thickened, with no stenosis. Moderate mitral regurgitation is noted with vena contracta 0.6 mm, ERO 0.3 cmsq and regurgitation fraction 42%
Tricuspid valve normal with no stenosis. Moderate tricuspid regurgitation, peak pressure gradient of 40 mm Hg.
Rest of the valves is normal in morphology with no stenosis and no regurgitation.
Estimated pulmonary artery systolic pressure is approximately 50 mmHg.
Normal transmitral inflow pattern. Normal pulmonary vein Doppler.
E/E’ is 7, suggestive of normal LV filling pressure.
No obvious thrombus, vegetation, pericardial effusion or intracardiac shunt.

Conclusion:
Cardiac chambers are of normal size.
Moderately reduced left ventricular systolic function.
Moderate mitral regurgitation.
Moderate tricuspid regurgitation.
Moderate pulmonary artery hypertension.
Helpful - 0
Avatar universal
Thelium Report

EXERCISE MYOVIEW SPECT MYOCARDIAL PERFSUION STUDY
AGE: 30 Years
INDICATION: IHD , to see reversible ischemia/viability
Isotope: 07 mCi of Tc-99m myoview at peak stress
              21 mCi of Tc-99m myoview at rest, 10 minutes after s/l nitrate (viability protocol)

Stress Test: Patient was exercised for 10.20 min reaching 4th stage of Bruce Protocol.
Pulse rate rose from 90/min to 191/min and BP from 120/90 mm Hg to 160/100 mm Hg.
Exercised was stopped due to dyspena and fatigue. His resting ECG revealed old inferio wall
mi. 1mm up sloping ST depressions were noted in inferolateral leads at peak stress, which
Reverted to baseline in the early recovery period. Maximal exercise, negative test with good
effort tolerance. Hypertensive response to exercise is noted.
SPECT images were acquired around an arc of 180 (RAO- LPO)
Scan Interpretation: scan shows medium sized fixed perfusion defect of moderate severity
Involve mid-cavity to basal inferolateral wall. There is no evidence of inducible ischemia/
Viability LV myocardium is normally perfused.
LV cavity is normal sized.
Conclusion:
Exercise myocardial SPECT study at 100% predicted HR and 10.9 METS is negative for inducible
Ischemia/viability
There is evidence of medium sized fixed perfusion defect of moderate severity involving mid-cavity to basal inferolateral wall.
Helpful - 0
Avatar universal
Thanxs for Helping
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Avatar universal
Bro,

Doc Said my one Artry is blocked and heart is also demmaged bcz of that blockage...........................what u think and recomend...........waiting

these are two reports above one is thalium and 2nd part is Echo
Helpful - 0
367994 tn?1304953593
Q:Cardiac chambers are of normal size.

>>>>no problem.  Usually when there is hypokinesis and lower than normal EF the left ventricle is enlarged.

Q: Moderately reduced left ventricular systolic function (35-40%)

>>>>>Normal systolic function has an ejection fraction of 50 to 70% which indictes the amount of blood pumped with each heartbeat.  Report indicates 42% of left ventricle chamber's capacity there is about 42% backward flow ofblood into upper chamber rather than pumped into circulation.

Q:Moderate mitral regurgitation.

>>>>Mitral valve is a one- way- pass of blood from the upper chamber to the lower chamber to be pumped into circulation.  The report indicates 42% of the blood is pumped back into the upper chamber due to the leaflets not tightly closing over the valve opening when the lower chamber pumps blood into circulation.  The mitral valve is thickened indicating calcification.

Q:Moderate tricuspid regurgitation.

>>>>There is backflow of the valve related to the rightside of the heart.  The rightside of the heart returns blood to the lungs to be oxygenated.

Q: Moderate pulmonary artery hypertension

>>>>>There is higher than normal resistence that the rightside of the heart pumps against when returning blood to the lungs.  The rightside pumping functionality is normal.

The stress test was stopped due to shortness of breath and fatigue.  There is some evidence of occlusion ( medium sized fixed perfusion defect of moderate severity).

Hope this provides a perspective that helps you.  Thanks for sharing and if you have any further questions or comments you are welcome to respond.  Take care,

Ken
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