abnormal dual-isotope stress test

[ALIENLOVER]

For almost 4 months now I have been having chest pains.  My 28 day monitor showed sinus arrhthmia, sinus tachycardia and some sinus bradycardia when I transmitted daily.  My heart rate is usually in the 42-54 range.  I have chest pain, shortness of breath and some stabbing pain..Some times the pain is a 8 out of 10.  I saw a cardiologist who told me at my age 39 natural selection says I am likley to have any cornary artery disease.  He stated my symptoms could be psychsymatic He ordered a nuclear stress test to confirm his suspicions.  He told me not to worry I am not at risk for a heart attack.  The stress test was preformed 1 week ago and he called and wanted to schedule a heart cath.  I refused to schedule any further procedures with him.  

The stress test images demonstrated the presence of a mixed though largely redistributed perfusion defect in the inferolateral segments.  The impression was: abnormal dual-isotope stress test with evidence on anterolateral ischemia and small anterior scar.  The global left ventricular systolic function was preserved with an LVEF of 60%.  Wall motion analysis demonstrated only mild decreased conractility of the interventricular septum.  The control electrocardiogram was normal.  There were EKG changes of chemically induced ischemial during adenosine infusion.  There was no dysrhythmia.    

Am I at risk for a heart attack??  How soon should I have a heart cath done?  I have chest pain every day when do I go to an ER or do I just live with it?

[erijon]

kenkeith is absolutely correct, you are at risk at this time and should make a cath a very high priority. The impressions on your report along with your symptoms all indicate possible blocked arteries, you need a cath to verify this fact and determine a course of action. You should feel good that your LVEF is still preserved, but as kenkeith said it can change very quickly, I would schedule a cath as soon as possible, don't try to out guess the cardiologist on this one. If you have chest pain you should go ahead and get to the ER, why take the chance, especially with your recent test results.

Good Luck,

Jon

[kenkeith]

You should see and be treated for angina.  Your LVEF at the present time is normal, but not have get treatment can cause a loss of LVEF and eventually lead to heart failure.  Report states preserved LVEF at the present time.

You have ischemia (lack of blood flow) usually due to some blockage of vessesl,  There is some hypokenesis (wall movement defect) causing some loss of LVEF (contractions).

At the present time there is no rhythm problem and apparently the heart isn't enlarged.  I doubt very much it is a psychological problem from what has been posted.

You are at a risk for an MI (heart attack) and heart failure...high risk!  Four days of angina may have already changed your condition since prior assessment.