Nuclear Myocardial Perfusion study, October 11, 2007?

Question

1ST stress and scan test
Findings: subtle perfusion defect on stress imaging involving the mid to apical inferior wall which improves on rest imaging. there is subtle mild hypokinesis of the apical portion of the inferior wall. the remainder of the wall motion is within normal limits. ejection fraction is greater than 55%. no persistent pcrfusion defects to suggest old infarct or scar.
IMPRESSION: 1. Mild ischemia involving the mid to apical portion of the inferior wall. 2. no fixed perfusion defects to suggcat old infaret or scar. 3. mild hypokinosis of the apical portion of the inferior wall, the remainder of the wall motion is within normal limits. the ejection fraction is greater than 55%.

2ND TEST
CORONARY ANGIOGRAPHY HEMODYNAMIC DATE
HEART IS NORMAL: LEFT MAIN CORONARY: NORMAL, LEFT ANTERIOR DESCENDING: NORMAL, LEFT CIRCUMFLEX: NORMAL, RIGHT CORONARY ARTERY: NORMAL, COLLATERAL CIRCULATION: NONE.
DID THE TEST CAUSED ?
WANT TEST IS FALSE ?
I DID I HAVE TO GET THE 2ND TEST

Answer 1

You see in your stress test, you study the status of myocardium, while the second test is the study of your coronary blood vessels and that too is correct.
To check the patency of your blood vessels, you will have to undergo angiography considered to be the gold standard.
So these are 2 different studies of your heart.
Keeping the technicalities aside, you should be thankful to God that you have a clean bill from cardiac angle as EF> 55%.
I hope you are satisfied, hope I am clear.
You can discuss it with your cardiologist.

Answer 2

....the nuclear perfusion scan is less specific and absolute, and more likely to be read as a "false positive"....actually your perfusion scan findings are only "borderline suggestive" of coronary artery disease, and in the words of the interpreting cardiologist "subtle, mild" and "improve on rest".....they are, however, suspicious enough to warrant the more exact study of coronary angiogram(cardiac cath), to rule out the possibility of a right coronary lesion, which is the usual culprit in such inferior wall changes......on cath film, according to report, the right coronary along with the LM, LAD, and CIRC., all are free from disease/occlusion, and the ejection fraction at 55% per nuclear estimation is within normal limits. (ejection fraction being the percentage of blood ejected from the L. ventricle upon contraction of the heart, normal is 55-65%).....In short, yes, your physician's closer look by cardiac cath was certainly warrented, and congratulations on your "clean-cath" results!!!!!

Answer 3

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