Heart Stress Test Results

I recently had a heart stress test. The kind using the nuclear imaging before and after treadmill test. Anyway, it came back that I had "partial reversible inferior posterior defects".  During exercise it was moderate to severe and then back to resting it was normal.

How common is this? How serious is it? And what methods of treatment is commonly use to remedy this?

I had went to the E.R. the night before this test because of rapid heart rate....it had went on for a long time before I went out the E.R. I had no chest pain, just concerned because the heart rate was up to 150. The heart rate came down to normal after I got to E.R. My primary care doctor considered that it could have been caused by an anxiety attack. Could this effect how the above heart stress test came out?

[Michael J. McWilliams, M.D.]

How common is this?

It is tough to say how common it is because I have selection bias. Most of the people that I see have real coronary disease.  The percentage of positives tests depends in part on the underlying risk of the population being screened.  The fewer risk factors that you have and the depending on the symptoms, this could be a true positive test and indicated that you have coronary artery disease or this could be a false positive test.  False positives are tests that are positive when the person being tested does not have the condition.  What I am saying is the percent of true positives varies depending on the underlying risk of the population being screened.

How serious is it?

It depends on if there is a blockage and where the blockage is.  The only way to know this is to have a heart catheterization.  Whether or not you need this depends on whether you are having symptoms that sound like coronary disease prior to the test.  Today's culture tends to get a cath and a stent if there are symptoms.  If there are no symptoms, the data also suggests that medical therapy is just as good.

And what methods of treatment is commonly use to remedy this?

If you are not have chest pains or a chest pain equivalent (shortness of breath with exertion, waking at night short of breath, swelling in legs, etc), medical therapy is shown to be just as good.  This would include controlling risk factors like smoking, diabetes, hypertension, cholesterol.  Some of this can be done with medications and others treated with diet.  If there is a hint of high blood pressure I would treat it.  There is also a very low threshold to treat patients with cholesterol if coronary artery disease is suspected.  A cath is indicated if you have chest pain or the equivalents listed above.

Could this effect how the above heart stress test came out?

there is no reason to believe that anxiety or a panic attack would cause a positive stress test.  The best thing to do is see a cardiologist and have the assess whether or not they think you need a heart cath.

Medical management is key if there is any indication that you may have coronary disease.

I hope this answers  your questions.  thanks for posting.