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What does this cardiolite stress examination indicate?

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General & Family Physician
Practicing since : 1980
Answered : 1 Question
Question
I just had a cardio lite stress examination and the finding was mild hypokinesis involving the basal lateral segment with no definite associated perfusion defect seen. However there is a small-sized mild intensity defect involving the apical segment. Ejaction fraction is 51%. No definite reversible ischemia. Should I be concerned?
Posted Wed, 27 Aug 2014 in General Health
 
 
Answered by Dr. Rahul Tawde 2 hours later
Brief Answer:
FURTHER EVALUATION NEEDED

Detailed Answer:
Hi, thanks for posting your concern in the HCM.
I don't think that it is a very wise decision to stamp the findings of stress test false positive based on results of cardiolite stress test.
Cardiolite stress test is very accurate with its positive results. But, it definitely comes up with false negative results.
Please have an angiogram done at the earliest. You may also be put on Aspirin/ clopidogrel and statins based on your cardiologist's advice.
Acid reflux may cause similar symptoms. But, the more serious cause, i.e. ischaemic heart disease must be excluded.
You may for the time being start taking Pantoprazole-Domperidone combination for symptomatic relief if there is heartburn.
However, please take a second opinion from another cardiologist and get an angiogram done at the earliest.
Please attach all the reports if you have any additional query. I would also like to know whether you have diabetes, hypertension etc.
In case you have any new query in future, you can directly ask me questions @ http://www.HealthcareMagic.com/doctors/dr-kaushik-sarkar/68460. I will try my level best to help you.
Regards,
Dr. Kaushik
Above answer was peer-reviewed by
 
Follow-up: What does this cardiolite stress examination indicate? 5 hours later
Thanks for your detailed answer. I am attaching the two reports i received. The treadmill test showed positive results for ischemia whereas the imaging did not. I have none of the risk factors. I am thin, have never smoked, do not have diabetes or a family history of early-onset heart disease. I am not short of breath, have no difficulty going up steps, and have had no swelling in legs or feet. For these reasons, the cardiologist felt that the treadmill test was off. He recommends another stress test in 6 months. I just wanted another opinion.
 
 
Answered by Dr. Rahul Tawde 2 hours later
Brief Answer:
Angiogram needed.

Detailed Answer:
Thanks for your early reply.
I saw both of the reports and yes, they are truly contradictory- one suggesting reversible ischaemia and the other not.
I should also say that your cardiologist was right in thinking that you are a low risk patient for ischaemic heart disease.
However, the protocol is to have an angiogram, if the reports of the above tests come out as contradictory.
And, secondly, I don't think one should bear the confusion of having or not having ischaemic heart disease for 6 months because this is a very serious condition and the acute attack of myocardial infarction is often fatal.
So, my opinion is you should take the opinion of another cardiologist and get an angiogram done at the earliest.
Best wishes for your health.
If you are satisfied with my answer, please close the thread and rate my answer.
For any additional questions, please write back.
Regards,
Dr. Kaushik
Above answer was peer-reviewed by
 
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