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What Do These Nuclear Stress Test And Calcium Score Indicate?
Question: i just had a nuclear stress test and they said i have slight interior wall ischemia, but my calcium cat scan was zero for blockage
Brief Answer:
I would explain as follows:
Detailed Answer:
Hello!
Welcome on HCM!
Regarding your concern, I would explain that it is true that sometimes there exists a discrepancy between overall coronary calcium score and the results of nuclear cardiac stress test.
This may be because not always a coronary lesion (atherosclerotic plaque) has a significant or detectable calcium burden.
From the other hand, myocardial ischemia, not always is caused by traditional epicardial coronary lesions (atherosclerotic plaque).
Sometimes, endothelial dysfunction, micro-circulatory insufficiency, coronary muscular bridge, or even coronary spasms may be responsible for myocardial ischemia pattern.
It is necessary to properly correlate between clinical symptomatology, presence of coronary risk factors (hypertension, diabetes, dyslipidemia, smoking, heredity for CAD, etc) and the conclusions yielded by different cardiac imagine studies.
If sufficient suspicions about cardiac ischemia are present, then such a pattern of inferior wall ischemia on nuclear stress test should be further investigated by additional imagine tests, such as coronary angiography.
In case the final reports of nuclear stress test and coronary angio CT are available, please upload them here for a direct review in order to be possible a more concrete professional opinion.
Hope to have been helpful to you!
If you have further uncertainties, feel free to ask me again!
Kind regards,
Dr. Iliri
I would explain as follows:
Detailed Answer:
Hello!
Welcome on HCM!
Regarding your concern, I would explain that it is true that sometimes there exists a discrepancy between overall coronary calcium score and the results of nuclear cardiac stress test.
This may be because not always a coronary lesion (atherosclerotic plaque) has a significant or detectable calcium burden.
From the other hand, myocardial ischemia, not always is caused by traditional epicardial coronary lesions (atherosclerotic plaque).
Sometimes, endothelial dysfunction, micro-circulatory insufficiency, coronary muscular bridge, or even coronary spasms may be responsible for myocardial ischemia pattern.
It is necessary to properly correlate between clinical symptomatology, presence of coronary risk factors (hypertension, diabetes, dyslipidemia, smoking, heredity for CAD, etc) and the conclusions yielded by different cardiac imagine studies.
If sufficient suspicions about cardiac ischemia are present, then such a pattern of inferior wall ischemia on nuclear stress test should be further investigated by additional imagine tests, such as coronary angiography.
In case the final reports of nuclear stress test and coronary angio CT are available, please upload them here for a direct review in order to be possible a more concrete professional opinion.
Hope to have been helpful to you!
If you have further uncertainties, feel free to ask me again!
Kind regards,
Dr. Iliri
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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