Stress Test Results

[Doctorisin]

I just got a stress test because of some pains I had in my chest.  On a followup appointment with my cardiologist, he indicated that my test results were normal.  In fact, the first pages summary of my results looked ok. Here are conclusions:

1.  Normal exercise dual-isotope myocaridal perfusion study.
2.  Normal gated SPECT left vetricular wall motion study.
3.  Normal gated SPECT left ventricular ejection fraction.
4.  Negative exercise electrocardiogram.
5.  Moderate exercise tolerance.
6.  No chest pain during exercise.
7.  No significant arrhythymias during exercise.

However, when I asked for a copy of the results, there was another page which was very confusing.  Here are the troublesome areas, for which I need help understanding...

"Threre is a small area of mild fixed perfusion defect seen involving the apical wall.  This is consistent with scar."

Does this mean that I have had a heart attack or something in the past that caused the scar?  How concerned should I be about this?

"The left ventricular funciton is mildly reduced with a gated EF of 48%.  There is inferior septal akinesis.  The stress gated EF is 57%."

What does this mean?  Is the gated EF different to the "Stress Gated EF."?  What is "inferior septal akinesis"?

"No transient sichemic dilation seen."  I guess this is good?

My doctor did not discuss the above results with me and I am confused. He said that everything was normal.

Please help.

Thanks.  Brian

[kenkeith]

QUOTE:Threre is a small area of mild fixed perfusion defect seen involving the apical wall.  This is consistent with scar."

>>>>Fixed perfussion (blood flow) indicates a scar disease as the tissue does not pass any blood flow.  Perfusion with rest and and impeded blood flow with exertion can indicate the heart is not receiving sufficient blood flow, and often due to some vessel blockage.  Scar disease is the result of a prior heart attack where heart cells did not get sufficient blood flow

QUOTE: "The left ventricular funciton is mildly reduced with a gated EF of 48%.  There is inferior septal akinesis.  The stress gated EF is 57%."

>>>>>The septum is the wall that separates the left and right side of the heart, and that appears to be the area of scar tissue.  Left ventrical is the pumping chamber, and because there is an impedement to heart wall movement that would be the underlying cause for the marginally reduced EF. The EF is the ejection fraction representing the amount of blood pumped with each stroke.  

QUOTE: What does this mean?  Is the gated EF different to the "Stress Gated EF."?  What is "inferior septal akinesis"?

>>>>> Stress gated EF would be the ejection fraction with stress induced perimeters.
Inferior septal akinesis indicates heart cells that do have and have not had ample blood supply.  And the location is noted.

QUOTE: No transient sichemic dilation seen."  I guess this is good?

>>>>>ischemic means lack of blood flow, so there is no enlargement of the heart due to lack of blood flow. If there is an advanced condition of ischemia the heart (left ventricle) will dilate to compensate, and if the underlying condition is not properly treated the LV will overcompensate and the EF will be higher than normal, and then decompensate to an EF below 30%...heart failure range.

If you have any further questions or comments you are welcome to respond.  What treatment are you receiving?  Is your EF with or without medication? Chest pain been diagnosed? What is the medication?  I had a heart condtion many years ago, hypokinesis, enlarged left ventricle, low EF...below 30%.  Curently with treatment my heart is normal size and pumping normally.

Take care and thanks for your sharing your medical condition.  Hope this has provided an insight and a perspective, and keep in mind that an EF calculation is an estimate, and changes throught the day as does heart rate and blood pressure to maintain a balance.  Wish you well going forward.  

[erijon]

Trust your doctor, not what non-medical professionals may tell you on the Internet. I'm sure your doctor reviewed the results carefully and determined everything is within normal limits and/or a normal variant. FYI, your EF should be between 50% and 75% so yours is fine at 57%.

Again, if you have questions you should schedule a time to discuss it with your doctor or ask this on the Expert Forum where a doctor can respond.

Hope this helps,

Jon