I'm 43 years old, went in for a heart screen that included coronary calcium score, LAD 187, LCX 152, RCA 885, total 1224 (YIKES). I am asymptomatic, excellent lipid panels and BP. I do have a family history heart disease and am overweight. I ended up doing a CPET with the following results:
STRESS EKG PORTION: Patient underwent Persantine PET protocol for 4 minutes and heart rate rose to 55% of the maximal age predicted heart rate. Stress EKG portion was non-diagnostic for ischemia.
FINDINGS: Stress perfusion images show a mild reduction in uptake in the distal anterior wall and apex with normalization on resting images. This is suggestive of mild ischemia in the distal left anterior descending artery territory. Gated perfusion images show normal wall thickening of all myocardial segments. Resting ejection fraction is 73%. Resting end diastolic volume 92 mL. Resting end systolic volume 25 mL. Stress ejection fraction 77%. Stress end diastolic volume 98 mL. Stress end systolic volume 23 mL. TID 0.98 is within normal limits. CT attenuation map reveals coronary calcification most prominently noted within the RCA and left circumflex and to a lesser degree within the left anterior descending coronary artery. Absolute flow quantifications shows global myocardial flow at rest of 0.61 mL/gram/minute which is normal. Global myocardial flow at stress is 1.88 mL/gram/minute which is mildly reduced. Global myocardial flow reserve is 3.05 which is normal.
1. Abnormal study. Low risk study.
2. Perfusion images are suggestive of mild ischemia in the distal left anterior descending coronary artery territory.
2. Normal left ventricular ejection fraction, cavity size, and wall motion.
3. Coronary calcification noted within the right, left circumflex, and to a lesser degree in the left anterior descending coronary artery.
4. Normal myocardial flow reserve.
Please help me understand this study.