What Does This Nuclear Stress Test After Having Pressure In Chest Indicate?

Posted on Tue, 27 May 2014

Question: Nuclear stress test performed after having some pressure in my chest.

Weight 181 height 66in
Rest heart rate: 63 Peak heart rate 175 = 98 % of predicted XXXXXXX heart rate.
Blood Pressure: Rest:: 114/80 Stress: 192/86
Total exercise 12:00' min. Stress test completed: Yes
Symptoms during test: Shortness of breath, hypertensive response
IMPORTANT ARRHYTHMIAS: none
Resting EKG: normal sinus rhythm, possible old inferior infarct
Stress EKG: no significant ST-T changes suggestive of ischemia.
Myocardial Perfusion Results:
Location : anterior, septum inferior Type: Equivocal
Myocardial Function Results: Post stress LVEF 60% LVEDV 95ml TID ratio 0.74 lung uptake Normal 0.32
Wall Motion: Post ETT gated SPECT revealed normal wall motion
TID and Heart and lung ratio appear normal
REPORT SUMMARY: These test results indicate a Equivocal anterior, septum and inferior
Gated SPECT shows normal wall motion

Recommendation: Coronary CTA or PET

The question is: what is "Equivocal anterior, septum and inferior".
MY family MD is scheduling a CTA?? what from this Stress Test 's result is triggering this additional test??

Answered by Dr. Prabhakar C Koregol (3 hours later)

Brief Answer:
It means no definite information

Detailed Answer:
Hi

Thanks for your query.

It main that test is not able to answer weather there is normal blood supply or not. there is possibility of blockage and less than normal blood supply to hearts front portion and lower part of left ventricle. it needs to be clarified by performing one more test as what is the significance. as suggested by your GP it is reasonable to go ahead with CTA. if it normal you don't have to worry.

If it is abnormal it would guide further retain and treatment.

Regards,

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Prabhakar C Koregol (12 hours later)

Thanks for initial response.
If CTA comes normal, what would it be a typical "preventive maintenance" treatment ??
If ABNORMAL and Blockage ; what determines if treatable with medication or if there is a need for surgery??

Answered by Dr. Prabhakar C Koregol (1 hour later)

Brief Answer:
Quit smoking

Detailed Answer:
Hi again,
My advise would be as follows:
-quit smoking
-daily walk for 45-60min
-maintain good lipids and weight would be preventive.

Abnormal CTA would be only suggestive and we need to confirm it with regular or conventional angiogram. than findings would guide further treatment. Need for surgery or medical management vs PTCA would depend on number of blockages, severity of block more than or less than 70%, and location of blockages.

Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Vaishalee Punj