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ECG test showed Myocardial perfusion is abnormal. Meaning? Should I take a second opinion?

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Cardiologist
Practicing since : 1998
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I am a very active 65 year old male who just underwent a NUclear Stress Test. My Cardiologist recommended a Heart XXXXXXX due to the results of the test. I have never had any chest pain. I run a couple of miles every other day. For the past several year I have had a abnormal EKG ((nonspecific Twave elevation) I also have palpitations on occasion. The treadmill portion of test showed I had good tolerance for exercise.,...negative ECG test for ischemia...no chest pain.
Test results: evidence of attenuation was absent. Left ventricular cavity normal and rest and stress. no abnormal lung activity...right ventricle is normal.
Conclusion: Myocardial perfusion is abnormal.
SHOULD I GET A SECOND OPINION OR ARE THE RESULTS OF THE TEST SUFFICIENT THAT ANY CARDIOLOGIST WOULD REQUIRE A HEART XXXXXXX There is some risk with the XXXXXXX isn't here.
Posted Fri, 27 Sep 2013 in Hypertension and Heart Disease
 
 
Answered by Dr. Sukhvinder Singh 23 minutes later
Brief Answer:
please upload reports.

Detailed Answer:
Respected sir
1. There is something amiss. Till the "conclusion" everything written is normal but in conclusion it is written "abnormal". Can you please upload the report with or without films? That may help. This may be a simple typographical error. But surely there is something missing.
2. If you can upload the whole report, I will be able to tell you more on this.
Waiting for your reply.
Sincerely
Sukhvinder XXXXXXX
Above answer was peer-reviewed by
 
Follow-up: ECG test showed Myocardial perfusion is abnormal. Meaning? Should I take a second opinion? 1 hour later
I uploaded the stress test results. MY scanner is broken so I had to use Photos.
Can you view the uploads?
 
 
Answered by Dr. Sukhvinder Singh 8 hours later
Brief Answer:
Please see details.

Detailed Answer:
Respected Sir
1. I apologize for delay in answering.
2. The report says that there is an area where the supply of blood to heart muscles seems to be abnormally low during the stress. Although everything else seems to be normal. Since there is a suggestion of reversible ischemia, next step is a cardiac XXXXXXX However, looking at all other factors, there is a possibility that this report may be false positive (the specificity of stress Nuclear MPI scan is ~85%-90%). The chances of false positive test increase if there is "left bundle branch block" in your ECG at baseline.
3. There are usually two options in such scenarios.
A. Discuss the report with primary cardiologist and with the physician who has reported it, especially stressing that subject has excellent exercise capacity without symptoms. After this, if they still agree that there is a defect, go for a second opinion on this scan.
B. Discuss with your primary cardiologist and directly go for cardiac XXXXXXX
Hope this clarifies the issue.
Please do write if there is anything else. I will be glad to elaborate further.
Sincerely
Sukhvinder
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