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Help interpreting nuclear stress test results?

Hello all, first and foremost thank you for your time. The results are as follows; The left ventricular size is mildly enlarged. Right ventricular size is normal. Left ventricular wall motion is normal. Rest and stress SPECT images show a MEDIUM TO LARGE SIZE AREA OF MODERATE TO SEVERE FIXED PERFUSION DEFECT WITHOUT ANY REVERSIBILITY IN THE INFERIOR MYCOARDIUM with normal wall motion consisitent with diaphragmatic attenuation. No evidence of inducible ischemia.

During the follow up appointment all I was told was that my stress test was normal. However if I knew the actual impression I would have asked right away.

Back story; I'm 26, male, never a smoker/drinker. Started experiencing very strong heart contractions however slow. Turns out I was in sinus arrhythmia. Echo was normal, ZIO heart monitor for 7 days showed one run of 7 beats VTACH, (follow up with EP doctor next month) however normal otherwise. I was caffeine free while wearing the ZIO FYI. Never any chest pain, just palpitations. I have been heavily drinking caffeine for the last 4 years (college, night shift... maybe 300-500mg caffeine every other day or so, sometimes daily. I have since cut out all caffeine aside a diet soda once per day. I've only had 1 palpitation in the last week, I feel much better overall. Guarantee the caffeine was the culprit(majority) for the palpitations. I was started on metoprolol 25mg daily .


Again, thank you for any feedback provided. I truly appreciate. Going through this is very nerve wracking.
2 Responses
Avatar universal
A lil confused by the report...

This is a nuc med scan...  So have you asked... There is clearly lack of perfusion ala ( blood flow/volume) over an area.  What is their comment.  What other tests have you had ?

2 Comments
h diaphragmatic attenuation means artifact... I'm all good. Now just an appoinment with EP on the 21st because the zio monitor said I had 7 beats of vtach
h diaphragmatic attenuation means artifact... I'm all good. Now just an appoinment with EP on the 21st because the zio monitor said I had 7 beats of vtach
Avatar universal
A lil confused by the report...

This is a nuc med scan...  So have you asked... There is clearly lack of perfusion ala ( blood flow/volume) over an area.  What is their comment.  What other tests have you had ?

8 Comments
Not sure what you mean. And the bottom of the post tells the other tests I’ve had. And also I’ve written that I didn’t see the impression until after I left the office
Nuc med stress test*
Sorry, I reread... I don't see the other test??

Just holter monitoring?
Zio monitor, and echo. EF was 63% on the stress test, 55-60% on echo. That’s all that has been done. I’m not sure what else testing would be done for this aside from an EP study. I had a X-ray chest it was negative. Ekg showed sinus arrythmia
Ejection fraction from the lv... Did they check the right ventricle?

There's a lot that can be done, including catheterization.

What are your main symptom
Right is normal, left on echo was normal however LV on stress said mildly enlarged.  Main symptom was feeling strong palpitations
I’m 26 a catch would show blockage I doubt it’s a CAD issue, I have an EP follow up this coming month
Did it say dilated or hypertrophy?

CAD, can be genetic that comes out in 20's... Coronary artery fistula as an example, causing steal.
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