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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Nuclear Stress Test, Left Ventricle Ejection Fraction 64% At Rest 61% Post Exercise,exercise Induced Ischemic ST Depression

I had stress test done which shows st depression so they ordered nuclear stress test (exercise induced) It showed st horizontal depression with exercise. the gated SPECT demonstrated normal, and perfusion spect study normal - left ventricle ejection fraction 64% at rest 61% post exercise. results - no scintigraphic evidence of exercise induced ishemia. In discordant wiht exercise induced ischemic ST depression but with normal myocardial perfusion scan, obtained at adequate level of exercise, low probability of occurence of a significant cardiac event. tx
Sat, 19 Jan 2013
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Cardiologist,  's  Response
That means with about 90% of confidence we can term your TMT as false positive. There are two things which are refraining me from making this statement with 100% certainty:

a). Stress Thallium is not a gold standard for example in triple vessel disease it may be normal ! So it
is never 100% true either way. Ejection Fraction increases with exercise not falls.

b). Horizontal ST Depression on TMT is also about 80% specific. In such situation the helpful criteria
are what for this was done or risk profile of the patient and what symptoms patient had at peak
exercise.


Consult your cardiologist with the available data I would go in for CT angio or regular coronary angiography
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Radiologist, Nuclear Medicine ,  Dr. Manoranjan Chowhan's  Response
Your question is answered by Dr Anil however if you need further elaboration please let me know I am a practicing Nuclear Cardiologist and can explain you the result of the test and advice further.

please use the premium Ask a Doctor feature.

Dr Chowhan
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Nuclear Stress Test, Left Ventricle Ejection Fraction 64% At Rest 61% Post Exercise,exercise Induced Ischemic ST Depression

That means with about 90% of confidence we can term your TMT as false positive. There are two things which are refraining me from making this statement with 100% certainty: a). Stress Thallium is not a gold standard for example in triple vessel disease it may be normal ! So it is never 100% true either way. Ejection Fraction increases with exercise not falls. b). Horizontal ST Depression on TMT is also about 80% specific. In such situation the helpful criteria are what for this was done or risk profile of the patient and what symptoms patient had at peak exercise. Consult your cardiologist with the available data I would go in for CT angio or regular coronary angiography