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Interventional Cardiology  (Expert Forum)
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inferior ischemia...can't wait for appt!?
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Truman Medical Center MO
Questions in the Interventional Cardiology forum are answered by medical professionals affiliated with the Truman Medical Center. Topics covered include acute coronary syndrome, angina, atrial fibrillation, cardiac catheterization, cardiomyopathy, drug abuse & cardiac disease, echocardiography, heart failure, hypertension & heart disease, lipid management, minorities and heart disease, peripheral vascular disease, prevention, valvular heart disease, women’s heart health, and the warning signs of a heart attack.

inferior ischemia...can't wait for appt!?

by alfer, Oct 16, 2007 11:26AM
My mother of 79 years with a history of hypertension, hyperlipidemia and diabetes was refered for a nuclear stress test for eval. of ischemia.  Risk factors: Avandia, Insulin, Prandin, Lipidor, Torsemide, Asa, & Cosar.
The results included...
MYOCARDIAL PERFUSION SCAN: Small inferior defect of mild intensity post excersise with normal perfusion images at rest.  The left ventricle was of normal size.  There was no transient ischemic dilation.
GATED WALL MOTION-  Normal left ventricular wall motion.
EJECTION FRACTION: 83%
CONCLUSION:  Abnormal exercise myocardial perfusion imaging with evidence of inferior ischemia.  EKG response was ischemic.  Blood pressure was appropriate.  Exercise tolerance was fair.  Gated wall motion analysis of the left ventricle reveals Normal left ventricular wall motion and ejection fraction of 83%.
QUESTION: How concerned should she be and what exactly does this report mean?  She is sleepless while awaiting an appointment to discuss these findings with the cardiologist.  Chest pain upon mild exercise was the impetus for the test.

by Douglas Bogart, MD, Oct 16, 2007 12:07PM
To: alfer
Your mother clearly needs to see the cardiologist, but this is not an emergency.  The abnormality on the scan is small and there were no high risk features on the study.  In addition the symptoms you reported are exertionally related.  If she were to have rest discomfort or pain being awakened from sleep--it would increase the urgencv of the cardiology visit.
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