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Heart Disease Community

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Heart pain

by Sheenrif, Jul 25, 2008 06:09AM
Pls have a look at the following, this is the medical status of my Father-in-Law.
Nowadays, he is not feeling well constantly, and have repeated uncomfort situations ( almost daily).

HISTORY:
Two heart attacks within a week time ( in November, 2005)…going towards heart failure.

SYPMTOMS (Current):
1. Feel like vomiting
2. Chest congestion
3. Pain towards heart and specially at the back side of heart (chest)
4. Pain in the left arm
5. Sweatening
6. Heart beat increase
7. When feel uncomfortable likes to sit and feel comfortable
8. When in pai face expressions show the pain
9. B.P (Normally): 110/70
10. B.P (After symptoms happening): < 90/60

REPORTS:
tests were done on: May 5th, 2008:

Patient’s I. D: 1076 Date: 06-05-2008
Age: 65yrs

Indication: Routine Cardiac Assessment.
History:
This is a 65 years old male patient non-smoker with a history of IHD. The reason for this examination is to evaluate for the extent of coronary artery disease.

Protocol Used: Stress, Rest Two day protocol.

Stress Test: ETT Negative for exercise induced ischemia.  

Exercise performed on Bruce protocol for 03:00 min, achieving 101% of target Heart Rate i.e. 158 BPM at 04.8 Mets.  ST Changes seen at peak exercise. About 740 MBq of Tc99m was injected at peak stress and exercise was continued for another two minute. Stress Study was conducted on 15-04-2008.
A similar type of study was conducted in resting state on 19-04-2008.

Resting HR= 94bpm B.P= 120/80 mmHg

Peak Stress HR= 158bpm B.P= 160/90 mmHg

Findings:
Review of the cine raw data showed mild vertical movement during acquisition. Left ventricle is enlarged.
The stress tomographic images demonstrate large perfusion defect in the anterior, inferior and apical wall of the left ventricle which shows slight improvement on resting images.

Gated SPECT Studies:
Based on the gated portion of the exam, regional wall motion analysis  shows global hypo-kinesis.
Stress:
EF:     28%             ED Vol:     301ml Es Vol:   216ml

Rest:
EF:      30%             ED Vol:    250ml Es Vol:   175ml

Conclusion:
 Severe fixed perfusion defect involving interior, apex and inferior wall of the left ventricle.

 Severe Global hypo-kinesia.

Please let me know he Measures, we should take or future.

Br,

Arif
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