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What Does My Stress Test Result Indicate?
Question: OK .Please can you explain this result of stress test? I do no understand anything. It is serious. Thank you My email: YYYY@YYYY
Thank you
FINDINGS:
Exercise stress data from Heart Station: Patient exercised for 2 minutes and 56 seconds; stopped because of shortness of breath. Heart rate peaked at 116 bpm (85% PMHR) and BP at 144/80. Preliminary ECG interpretation: Negative for ischemic ST-T wave changes. Duke treadmill score: 3 .
Cardiac functional parameters calculated from post stress gated imaging data with volumes indexed to patient's BSA (limits of normal in mL/sq M):
LV end diastolic volume: 38.0 mL/sq M (females, <60; males, <75).
LV end systolic volume: 15.7 mL/sq M (females, <27; males, <39).
LV ejection fraction: 58% (females, >51%; males, >43%). Compared to calculated parameters at rest: no significant changes.
Cardiac imaging: Stress and rest myocardial perfusion images show normal right and left-ventricular size with overall normal global systolic function stress images show a moderate size mild grade anteroseptal and apical defect occupying 10% left ventricular myocardium this defect is partially fixed and partially reversible on rest images with approximately 6% of left ventricular myocardium showing reversibility these findings are consistent with myocardial scarring with peri-infarct ischemia gated study shows no definite wall motion or thickening abnormalities left ventricular ejection fraction is normal 50%.
IMPRESSION / COMMENT: Moderate size mild grade anteroseptal and apical defect partially fixed and partially reversible on rest images consistent with myocardial scarring with significant peri-infarct ischemia. The prior study from May 2011 showed a small size mild grade apical lateral
Thank you
FINDINGS:
Exercise stress data from Heart Station: Patient exercised for 2 minutes and 56 seconds; stopped because of shortness of breath. Heart rate peaked at 116 bpm (85% PMHR) and BP at 144/80. Preliminary ECG interpretation: Negative for ischemic ST-T wave changes. Duke treadmill score: 3 .
Cardiac functional parameters calculated from post stress gated imaging data with volumes indexed to patient's BSA (limits of normal in mL/sq M):
LV end diastolic volume: 38.0 mL/sq M (females, <60; males, <75).
LV end systolic volume: 15.7 mL/sq M (females, <27; males, <39).
LV ejection fraction: 58% (females, >51%; males, >43%). Compared to calculated parameters at rest: no significant changes.
Cardiac imaging: Stress and rest myocardial perfusion images show normal right and left-ventricular size with overall normal global systolic function stress images show a moderate size mild grade anteroseptal and apical defect occupying 10% left ventricular myocardium this defect is partially fixed and partially reversible on rest images with approximately 6% of left ventricular myocardium showing reversibility these findings are consistent with myocardial scarring with peri-infarct ischemia gated study shows no definite wall motion or thickening abnormalities left ventricular ejection fraction is normal 50%.
IMPRESSION / COMMENT: Moderate size mild grade anteroseptal and apical defect partially fixed and partially reversible on rest images consistent with myocardial scarring with significant peri-infarct ischemia. The prior study from May 2011 showed a small size mild grade apical lateral
Brief Answer:
Explanations to your report...
Detailed Answer:
Hi and thank you for asking to HCM!
I read your query very carefully. Based on the data you provided I will try to explain it to you.
You have worked for 2 min and 56 minutes and have reached a HR >85% (this is needed to reach a predictive value). ECG before exercise was normal.
The imaging taken during the stress show the following anomalies:
- A moderate size anteroseptal and apical feeling defect, which is a sign of ischemic heart disease.
- This feelin defect is partially fixed (this is the sign of prior myocardial infarction, i.e "myocardial scar"), and partially reversible (this is sign of on going ischemia in the area around the previous infarction).
- Left ventricule has a normal Ejection Fraction.
My conclusion is that there's a clear sign of exercise induced ischemia in anteroseptal and apical area. There's a myocardial scar in this area which is a sign of a previous myocardial infarction.
Based on this report I also recommend doing angiography for a better evaluation of ischemic heart disease.
Hope this will answer to your query!
Dr. Benard
Explanations to your report...
Detailed Answer:
Hi and thank you for asking to HCM!
I read your query very carefully. Based on the data you provided I will try to explain it to you.
You have worked for 2 min and 56 minutes and have reached a HR >85% (this is needed to reach a predictive value). ECG before exercise was normal.
The imaging taken during the stress show the following anomalies:
- A moderate size anteroseptal and apical feeling defect, which is a sign of ischemic heart disease.
- This feelin defect is partially fixed (this is the sign of prior myocardial infarction, i.e "myocardial scar"), and partially reversible (this is sign of on going ischemia in the area around the previous infarction).
- Left ventricule has a normal Ejection Fraction.
My conclusion is that there's a clear sign of exercise induced ischemia in anteroseptal and apical area. There's a myocardial scar in this area which is a sign of a previous myocardial infarction.
Based on this report I also recommend doing angiography for a better evaluation of ischemic heart disease.
Hope this will answer to your query!
Dr. Benard
Above answer was peer-reviewed by :
Dr. Yogesh D
Thank you for your prompt response.
If the angiography shows an on going process of ischemia what are the steps to fix it, alternatives and risks.
Thank you . I am looking forward to hearing from you soon. Regards XXXX
If the angiography shows an on going process of ischemia what are the steps to fix it, alternatives and risks.
Thank you . I am looking forward to hearing from you soon. Regards XXXX
Brief Answer:
Different fixing options for your problem...
Detailed Answer:
Hi XXXXXXX and welcome back!
If the angiography shows an on going process of ischemia there are two steps to fix it.
1. Coronary angioplasty and stenting (PTCA), which is the best option in one or two vessels disease (number of stenosis within the coronary artery). This is a minor invasive procedure, which doesn't require general anesthesia and has a fast recovery (they will discharge from hospital after two days). It has a low mortality rate 2-5%.
2. Coronary bypass surgery (CABG). This is the best option in diffuse coronary involvement and left main arteries disease. This is a major invasive procedure with a longer recovery. Mortality rates are high 7-12%.
As you can see the decision are make based on angiography result and the severity of coronary arteries disease.
Hope this answer your queries!
Dr. Benard
Different fixing options for your problem...
Detailed Answer:
Hi XXXXXXX and welcome back!
If the angiography shows an on going process of ischemia there are two steps to fix it.
1. Coronary angioplasty and stenting (PTCA), which is the best option in one or two vessels disease (number of stenosis within the coronary artery). This is a minor invasive procedure, which doesn't require general anesthesia and has a fast recovery (they will discharge from hospital after two days). It has a low mortality rate 2-5%.
2. Coronary bypass surgery (CABG). This is the best option in diffuse coronary involvement and left main arteries disease. This is a major invasive procedure with a longer recovery. Mortality rates are high 7-12%.
As you can see the decision are make based on angiography result and the severity of coronary arteries disease.
Hope this answer your queries!
Dr. Benard
Above answer was peer-reviewed by :
Dr. Raju A.T
Thank you. I have another question, I am a 85 years old man and have some problem with my kidney due to old age, as my nephrologist says. The level of creatinine in the blood is 1.23, the BUN 17 and the GFR no Afro-American 53. What is the degree of risk for the kidney with angiography or angioplasty and stenting (PTCA)? I do not want to fix a problem and generate another.Thank you. I am looking forward to hearing from you. Regards, XXXX
Brief Answer:
The risk of renal damage is very low...
Detailed Answer:
Hi back!
Your creatinine levels and BUN are within the normal range so the risk of renal damage from Angiography and PTCA is very very low.
More over I suggest consulting a nephrologist before procedure to begin pre-medications to prevent it. Doing so you minimize the risk of having renal damage from this procedure.
Hope this was of help!
Dr. Benard
The risk of renal damage is very low...
Detailed Answer:
Hi back!
Your creatinine levels and BUN are within the normal range so the risk of renal damage from Angiography and PTCA is very very low.
More over I suggest consulting a nephrologist before procedure to begin pre-medications to prevent it. Doing so you minimize the risk of having renal damage from this procedure.
Hope this was of help!
Dr. Benard
Above answer was peer-reviewed by :
Dr. Ashwin Bhandari
Answered by
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