PLEASE!!What is Significence of following symptoms if any?

[fluffypurrcat]

HI, with less than one day till my Cardiac Catherization, I wonder if somone can give me some enterpretations of the following.

EKGS that say: ST-T changes in the lateral Leads, more pronounced than one year ago, and Borderline abnormal changes possibly due to myocardial ischemia
EKG Test year before was Sinus Brachacardia ( 46 beats per minute ) and Inferior and lateral ST And T changes Borderline abnormal, possibly due to Myocardial Ischmia ,and another recent one during stress test that says Non Specific ST and T changes( taken during the resting part of my test, heart rate was 54 beat per minute) Abnormal stress test was Stress with SESTAMBI Myocardial Perfusion.

Results were There was a Reverse Perfusion Defect in the inferospeptal region and this is associated with hypokinesis of septum and inferior septum near cardiac apex and mid cardiac segment. Does not perfuse normaly on stress imaging. The significence of a reverse or paradoxical perfusion defect varies but this condition may indicate a Recent MI. Also says the reversed perfusion defect may indicate an areal of recent infarction o resting imaging and stunned myocardium on stress imaging.

       I have repeatly asked for any information on these finding, but nobody seems to be able to help. I would feel better going in tommorow with my catherization if I had a little bit more information. Your help would be very much appreciated, even if you just want to guess, it is ok.    Thank you .                        fluffypurrcat

[maggiemag]

I'm sorry you are frustrated, but I think we haven't answered your questions satisfactorily because they are kinda technical and we are not physicians.  Here is what Wikipedia says about a stunned myocardium:

In cardiology stunned myocardium is a state when some section of the myocardium (corresponding to area of a major coronary occlusion) shows a form of contractile abnormality. This is a segmental dysfunction which persists for a variable period of time, about two weeks, even after ischemia has been relieved (by for instance angioplasty or coronary artery bypass surgery).  In this situation, while myocardial blood flow (MBF) returns to normal, function is still depressed for a variable period of time.

Until they get in there during the cath, it is anybody's guess as to what is really going on.......just a guess.  What does your cardiologist say?  That's what really matters.

[erijon]

I can certainly understand how your must be feeling. I wish I had enough knowledge t answer all your questions but I will tell you what I can glean from you post.

Your test shows an area of you heart, in the inferospeptal region, that has a reversable perfusion defect. My understanding is that this means it does not have adequate blood flow to the area under stress, less than when you are at rest due to the amount of tracer that reaches the area under both scenarios. More makes it into the muscle at rest than during stress when there is more demand. Simply put, when at rest your arteries are open enough to get suffucient blood flow which does not happen with stress (exercise). This is called reversabe because the muscle itself is not dead and the perfusion defect can usually be fixed with a stent depending on the anout of blockage. This is backed up by the finding of hypokinesis which is a reduced motion of the affected muscle. There is a chance that a recent MI has caused your heart muscle to go into hibernation which means the cells are stunned but can still be viable. This will require meds and cardiac rehab if this is the case. I wish I knew more about KG findings but I don't so I don't want to give you a bad answer.

I hope this helps and everything goes well for you tomorrow, please let us know how you're doing.

Jon

[momtofourboys]

I just want ot wish you good luck tomorrow. I am sorry I can't be of any help to your questions.
Please keep us posted on how things went. I won't be able to check in with you until at least Friday when my 4 year old comes home from his cardiac cath and electophysiology study.
good luck
michelle

[fluffypurrcat]

Hi, thank you for the response. I understand that nobody here is a dr. and that they can not give answers to things they don't know, but I was hoping someone else has had this same scenario. I appresiate the answers you give though, I worked as a nurses Aide for many years, but cardiology was not something I ever came across, so I am not familiar with any of this. All of this is new to me since my " Apparent MI " of April 2'nd, 08.

     As for asking my cardiologist has not been of much help, because he is new, I was referred to me, and he is doing this catherization to find out what is going on, because he was not sure. ( My angina for example, was not a result of exercise, it came on with no warning or at no particular time.) my Dr. who referred me has been my biggest supporter and with out her help, I was having a hard time even getting in to see a cardiologist.
       Thank you for the explanation of the STunned Myocardium, I still do not totally understand and I think this is because I won[t be abe to untill the Catherization shows what is going on inside my heart. I don't have that much longer to wait and soon I will know what is going on. My biggest fear has been that nothing would be done, and at least now I know something is being done so I am very lucky to be able to get this done. Some people have to wait and wait and wait. I guess my age has been a vantage point in some ways. If I was younger, they would probably rule out heart disease not scientifically but just mathematically and I would still be sitting here guessing.

          Thank you so much. I will let you know what I find out.        Fluffypurrcat

[fluffypurrcat]

Hi Michelle, thank you so much for the wel wishes. I certainly hope that your son finally gets the care he so deserves and that you get the answers you have been looking for so long. I wish him the best of care and that his cath and electrophysiciology tests give you the answers to his problems. It is so distressing when your child has a condition like this, esp, when they are so young.

           Does he have to stay in the hospital while having these tests, or is he having this done on an outpatient basis?It seems like it took you forever to get him a appt didn't it??
When I am having my test tommorow, I will be thinking not just of my own results but of what is going on with your son, I wish you all the best. I know you will finnally get the answers you have been praying for. Best wishes,                     fluffypurrcat

[fluffypurrcat]

Hi Jon, thank you so much for your response.I think you did a very good job of explaining this to me. I think I understand the technical jargon better now. I kept looking up Reverse perfusion Defect, and kept getting nowhere. There is not a lot of info on that term, and what little there is makes no sense to me.I do have one question though: if it is not a MI that caused the heart muscle to go into Hibernation ( Stunned) of part of the heart muscle, the inferoseptal region, what else besides a MI would cause this condition.?? It allso makes sense that the attack I had was not at rest,not exercise, but I have been under a lot of stress and that fits.I hope this is the case and a stent will fix this.
For whatever reason, I am more knowledgeable and feel a bit more relaxes anyway. I can go into the catherization tommorow , feeling perhaps I know a little bit more about my heart and what the stress test revealed. I will have to look up Cardiac Rehab and see what that is all about.

        I hope you are doing well yourself.Do not worry about giving me a " Bad Answer" at this point I did not have any real answers, and just wanted to learn some more. Thank you very much for taking the time and concern to answer my questions. I really appreciate it more than you could imagine. It makes it easier to try and sleep tonight.

   Thank you again.                                             fluffypurrcat

[erijon]

You are very welcome. It pretty much had to be an MI to cause cells in your heart to be damaged or stunned. It could have been a slient MI without symptoms. Your MI could also been the result of a vaso spasm where the arteries constrict causing the damage due to a lack of blood flow, although I don't think it would show up on a nuclear stress tests unless it was happening at the time of the test. It could also be a congenital defect in your cardio vascular system in which you have small or narrow arteries, my mother is that way and it has caused her some troubles like yours.

In any case, you'll have all the answers tomorrw, that should be a relief! Don't worry about a cath, it has a very low complication rate and I would gladly have one tomorrow if I was asked to. I know it probably doesn't help, but get a good night sleep and look forward to getting this behind you tomorrow. I'll be headed to Denver for business tomorrow but will check in with the forum to see how you're doing!

Good luck and stay in touch.

Jon