Radiologic Exam Report

My husband is 40 years old and had a stress test with 4 mci of t1=201 at rest and 28 mci or tc 99m tetrofosmin at stress. All spect images were attenuation corrected and utilizing the symbia t6 system and the stress spect images were gated. The findings say there is a predominantly fixed with mild reversibility defect at the anteroseptal wall thus cannot rule out a component of ischemia. Fixed inferior wall thinning which appears to be worsened at rest suggesting diaphragmatic attenuation artifact. End diastolic volume is slightly above upper normal measuring 147 ml with normal wall motion and ejection fraction of 58%. Impression is mild reversibility with predominantly fixed defect in the anteroseptal wall, thus cannot rule out a small ischemic component. Normal motion with ejection fraction of 58% and a slight increased in the end diastolic volume.

We don't understand all of this and it doesn't sound good but can't get this all explained to us. Can you help to explain what this means?  Thank you.

[Douglas Bogart, MD]

The nuclear scan is mildly abnormal and could suggest blockage in the left anterior descending coronary artery.  However this could also be explained by chest wall attenuation of the radioisotope and so could be an artifact of the test with no underlying pathology.  Is your husband a large man and if so the later may be the explanation.  If he is able to exercise on a treadmill an exercise echocardiogram might be a way to avoid a heart cath if this study were normal.

[muppie]

A related discussion, what is diaphragmatic attenuation? was started.