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Had bifascicular block and BP. Done with nuclear stress test. Give information regarding blood supply to heart?

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Practicing since : 1998
Answered : 1256 Questions
I need a better information of my blood supply to my heart than the report attached.
Do these pictures have any objective information ?
if so, how much can be explained to a lay man like me.

Earlier consulted question
I have a bi fascicular block.
A a BP issue.
I did a nuclear stress and the report came negative.
It mentioned no inducible ischemia
How can i know whether my RCA and LCA are ok ?
I do have lot of colour photos from the test
Posted Thu, 19 Sep 2013 in Hypertension and Heart Disease
Answered by Dr. Sukhvinder Singh 40 minutes later
Brief Answer:
Normal stress test, details below.

Detailed Answer:
Dear Sir
1. I have gone through the pictures and report you have uploaded. I will discuss this in detail in following lines but with a rider. These Films or pictures which we provide to the patient are not the total or 100% information. They are only the representative samples. The physician who is actually looking at your scan examines much more data than this sample films.
2. Yes these reports carry some objective information too.
A. At the age of 45 years If you are able to do 9 minutes 20 seconds of TMT without any symptoms/ problems (hope this was done on XXXXXXX protocol; not actually mentioned in these reports), your exercise capacity is excellent. This is a strong prognostic indicator and portends a healthy heart.
B. The films you have provided as well as the report of the physician mentions that the blood supply to your heart in resting condition is adequate and it rises normally with stress (exercise) and there was no deficiency of blood supply to heart at peak stress. The concept behind this statement is "Had there been a significant blockade in your RCA pr LCA, the blood supply to your heart at peak exercise would have been compromised/ deficient.
C. Your baseline Ejection fraction is 68%. That is the pumping of your heart is good.
D. Now the meaning of this test. The test says that the likelihood of a significant blockade in your RCA /LCA is low. There is no evidence of a heart attack in past. It also says that you have a very good exercise capacity (assuming you did not get any symptoms on treadmill). It does not show the RCA or LCA directly, neither it tells about the blockade which are lower than level of criticality (usually <70%).The test does not guarantee that you will not have a heart attack in future. However a good exercise capacity is always a favorable thing.
3. I would recommend you to have good control of your blood pressure and cholesterol, do exercise daily in consultation with your cardiologist, do not smoke try to maintain ideal weight and try to remain stress free. These are the things which will help you in avoiding heart attack in future.
Hope this helps.
Feel free to discuss further.
Above answer was peer-reviewed by
Follow-up: Had bifascicular block and BP. Done with nuclear stress test. Give information regarding blood supply to heart? 10 hours later

Thanks doctor for wonderful information.

My bi-fas block is attributed to a degenerative disease.

An electro physilogist mentioned that this is not significiant correlated to my conditions.

Do the de generative disease has a substance and form for the medicine ?

or it is one of the usual factors beyond the realms of science ?

It has been almost 50 years that the heart has been transplanted.
A conduction block on two fascicles have no reason attributed other than ageing.

Sorry to bother you doctor.

While your answers are very useful, given the limited information, appreciate if you can share any information.

Answered by Dr. Sukhvinder Singh 13 minutes later
Brief Answer:
See details please.

Detailed Answer:
Dear Sir
1. Yes you are right to some extent. Most of the time when patient presents to us with monofascicular or bifascicular or even complete heart blocks and we do not find any evident cause for it, we attribute it to degeneration or aging. There can be other causes like ischemic heart disease, drug effects, certain infections of heart (lyme disease), congenital heart diseases (AV cushion defects), Extension of calcification or infection from base of a valve to the fascicle.
2. The reassurance which we give to the patient about a certain type of block depends not only on the cause of block but more on the type of block. The knowledge of natural history of block tells us about its seriousness. For example an isolated "left anterior hemiblock" is more likely to remain so throughout patient's life and do not progress to complete heart block. However a combination of Left anterior hemiblock, right bundle branch block and first degree AV block can be more XXXXXXX So it depends upon the morphology you have in your ECG.
3. These blocks are electrical phenomenon and are not directly related to blockade in arteries. Major risk associated with them is complete heart block (i.e. complete "electrical cut off" of pumping chambers from receiving chambers). It does not pertain to any physical blockade.
Hope this gives you better insight.
Sukhvinder Singh
Above answer was peer-reviewed by
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