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Stress Test Med Induced.
Jun 05, 2008 10:14PM
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I saw my regular Dr. on April 21,st 08. Needed presurgical clearance for foot surgery, fusion scheduled on May 1st, 08. Due to the what she termed, " Classic MI syptoms, " she referred me for a Stress test, and put me on Nitro along with Zetia added to the meds I already take for Cholesteral, blood pressure, etc.
April 28th, 08 . After fasting, had one day rest and Dipyridamole Stress Sestamibi Myocardial Perfusion Scan and Cardiac Wall motion analysis.
Pt recieved on resting, an IV nuclide dose of 10 MCI technetium esstamibi followed by three plane gated SPECT resting imageing.
A Nuclide dose of 30 MCI technetium Cardiolite was administered IV was given slowly over 3 minutes followed by three plane gated SPECT stress images of the heart.
FINDING: MYOCARDIAL PERFUSION--THERE IS NORMAL PERFUSION OF THE LEFT VENTRICULAR MYOCARDIUM AT STRESS WITH NO SEGMENTAL STRESS PERFUSION SCORE GREATER THAN 1.
THERE IS DECREASED PERFUSION AT REST IN THE INFEROSEPTAL REGION. THIS REVERSED PERFUSION
DEFECT MAY INDICATE AN AREA OF RECENT INFARCTION ON RESTING IMAGING AND STUNNED
MYOCARDIUM ON STRESS IMAGING.THIS REVERSE FINDING MAY OCCUR WITH A RECENT INFARCTION.
WALL MOTION / VIABILITY. THERE IS NORMAL CONTRACTILITY ( THICKENING ) ON GATED STRESS
IMAGING.. GATED 3 D WALL MOTION DISPLAY ( MYOMETRIX ) DEMONSTRATES NO EVIDENCE OF
HYPOKINESIS OR DYSKINESIS.
IMPRESSION. THERE WAS A REVERSE PERFUSION DEFECT IN THE INFEROSEPTAL REGION AND THIS IS
ASSOCIATED WITH HYPOKINESIS OF THE SEPTUM AND INFERIOR SEPTUM NEAR THE CARDIAC APEX
AND MID CARDIAC SEGMENT. THIS AREA DOES NOT PERFUSE NORMALLY ON STRESS IMAGING. THE
SIGNIFICENCE OF A REVERSE OR PARADOXICAL PERFUSION DEFECT VARIES BUT THIS CONDITION MAY
OCCUR WITH A RECENT MI, PARTICUALLRY AFTER REVASCULARIZATION OR THROMBOLYTIC THERAPY.
CLINICAL CORRELATION IS ADVISED.OVERALL EJECTION FRACTION IS NORMAL. NO OTHER AREAS OF HYPOKINESIS SEEN.
AFTER given the results of this test, this is when my regular dr. referred me to the cardilogist to be seen. I was happy thinking it meant that I did indeed have a MI or something similiar that meant I was not going crazy or imagininag things. I was glad I was going to get some answers. Silly me, if it was only that simple. LOL
Oh, I was given the med induced STress test because I have a bad back and bad foot, two recent foot surgeries.
April 28th, 08 . After fasting, had one day rest and Dipyridamole Stress Sestamibi Myocardial Perfusion Scan and Cardiac Wall motion analysis.
Pt recieved on resting, an IV nuclide dose of 10 MCI technetium esstamibi followed by three plane gated SPECT resting imageing.
A Nuclide dose of 30 MCI technetium Cardiolite was administered IV was given slowly over 3 minutes followed by three plane gated SPECT stress images of the heart.
FINDING: MYOCARDIAL PERFUSION--THERE IS NORMAL PERFUSION OF THE LEFT VENTRICULAR MYOCARDIUM AT STRESS WITH NO SEGMENTAL STRESS PERFUSION SCORE GREATER THAN 1.
THERE IS DECREASED PERFUSION AT REST IN THE INFEROSEPTAL REGION. THIS REVERSED PERFUSION
DEFECT MAY INDICATE AN AREA OF RECENT INFARCTION ON RESTING IMAGING AND STUNNED
MYOCARDIUM ON STRESS IMAGING.THIS REVERSE FINDING MAY OCCUR WITH A RECENT INFARCTION.
WALL MOTION / VIABILITY. THERE IS NORMAL CONTRACTILITY ( THICKENING ) ON GATED STRESS
IMAGING.. GATED 3 D WALL MOTION DISPLAY ( MYOMETRIX ) DEMONSTRATES NO EVIDENCE OF
HYPOKINESIS OR DYSKINESIS.
IMPRESSION. THERE WAS A REVERSE PERFUSION DEFECT IN THE INFEROSEPTAL REGION AND THIS IS
ASSOCIATED WITH HYPOKINESIS OF THE SEPTUM AND INFERIOR SEPTUM NEAR THE CARDIAC APEX
AND MID CARDIAC SEGMENT. THIS AREA DOES NOT PERFUSE NORMALLY ON STRESS IMAGING. THE
SIGNIFICENCE OF A REVERSE OR PARADOXICAL PERFUSION DEFECT VARIES BUT THIS CONDITION MAY
OCCUR WITH A RECENT MI, PARTICUALLRY AFTER REVASCULARIZATION OR THROMBOLYTIC THERAPY.
CLINICAL CORRELATION IS ADVISED.OVERALL EJECTION FRACTION IS NORMAL. NO OTHER AREAS OF HYPOKINESIS SEEN.
AFTER given the results of this test, this is when my regular dr. referred me to the cardilogist to be seen. I was happy thinking it meant that I did indeed have a MI or something similiar that meant I was not going crazy or imagininag things. I was glad I was going to get some answers. Silly me, if it was only that simple. LOL
Oh, I was given the med induced STress test because I have a bad back and bad foot, two recent foot surgeries.
Just a note, that between April 2nd with orginal MI symptoms till last monday, May 26th,, I have been having angina attacks, or similiar episodes. NO warning or these attacks. Pressure in chest, squeezing tightness, wave of nausea, shortness of breath, faint feeling, palpatations, rise in blood pressure, sweating, and fear. Episodes last less than 10 minutes in general. Last episosde was a week ago. Becomming further apart it seems. NOt exercise induced, perhaps stress though.
June 2nd, Went into hospital for cardiac Catherization. Catherization revealed no significent blockages.
Impression: Normal Right dominant Coronary Arteries.
June 3rd. Severe back pain, ( longstanding chronic back pain.) should have been resting, but had other dr. appt I needed to keep.
June 4th, Severe right sided neck and shoulder pain and severe muscle spasms, Went to Urgent care and was given Pain meds and muscle relaxers.
June 5th, At dr.s office for Echocardiogram.Very short, only 15 minutes. Heard my heart, sounded strange and not very smooth sounding but that is probably normal. Also sort of diminished or weak sounding, not loud or strong. Was told dr. would go over results, I have an appt to see the dr. on the 17th, so in the meantime I guess there is not much else I can do.
If there are no problems with the walls, the chambers, blood flow, etc, then I don't know what else is left, but to wait and see if I have another severe episode. So frustrating, and I wish I had gone to the ER when I had the initial episode.
June 2nd, Went into hospital for cardiac Catherization. Catherization revealed no significent blockages.
Impression: Normal Right dominant Coronary Arteries.
June 3rd. Severe back pain, ( longstanding chronic back pain.) should have been resting, but had other dr. appt I needed to keep.
June 4th, Severe right sided neck and shoulder pain and severe muscle spasms, Went to Urgent care and was given Pain meds and muscle relaxers.
June 5th, At dr.s office for Echocardiogram.Very short, only 15 minutes. Heard my heart, sounded strange and not very smooth sounding but that is probably normal. Also sort of diminished or weak sounding, not loud or strong. Was told dr. would go over results, I have an appt to see the dr. on the 17th, so in the meantime I guess there is not much else I can do.
If there are no problems with the walls, the chambers, blood flow, etc, then I don't know what else is left, but to wait and see if I have another severe episode. So frustrating, and I wish I had gone to the ER when I had the initial episode.
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