my husband had heart testing. He is going in friday for a heart cath test. We are scared because we do not understand the first tests nor we understand what may happen on the cath test. first test was treadmill stress test. sestamibi scan results were: a transmural perfusion defect in the distal inferior and infero apical wall that is fixed on stress and rest imaging. gated images showed minimal inferior wall hypokinesis impression was: fixed inferior and infero apical defect consistant with soft tissue attenuation or prior infraction, no evidence for reversible ischemia , but mild inferior wall hypokinesis with ejection fraction of .50. The stress test results: bruce protocol 8 minutes into stage 4. maximal heart rate was 140 ---80% of predicted rate. normal BP, no arrhythmias, 13 mets of excertion, no pain, no ischemia
Can anyone help us understand these????? Your husband actually did very well on the treadmill test. 13 mets is a lot of stress and work without a sign of blocked arteries or "reversible ischemia." The fixed inferior wall defect is a borderline finding and may represent soft tissue attentuation or artifact. They can't be sure however that this may indeed represent a prior infarction (unrecognized heart attack). The hypokinesis is a mildly weakened area of the heart that may also represent a prior heart attack. Because these results are not clear and it is very important for you to know the outcome without doubt they recommended the heart cath. This will tell without any guesswork if you have blocked arteries, how badly blocked they are and how many are blocked. It will also tell definitively if you have had a silent heart attack in the past. It may however, just as well may tell you that your heart is entirely normal and that is what I would hope for. sounds like they suspect blood flow to or thru the heart is restricted on one side...
the heart cath is the one test where they'll find out 100% for sure what is happening...they send a camera up to the heart thru his main groin vein and take a look... he'll be awake but won't feel anything......what you need to do it take the big words and get definations for them and then put the pieces all together yourself... my doctors, like yours it sounds like are very leary to say what is going on till they know for sure...
per鈥u鈥ion (p蓹r-fy奴'zh蓹n) n.
1. The act of perfusing.
2. The injection of fluid into a blood vessel in order to reach an organ or tissues, usually to supply nutrients and oxygen
transmural
Passing through a wall, as of the body or of a cyst or any hollow structure
hypokinesis
Lack of, or insufficient, regular exercise and movement of the body your best bet would be to put all of your questions in writing & ask your DR to explain to you in simple language so that you have a good understanding.
To most of us not in the medical field, the above is non-understanding.
Best of luck, I do know that many good treatments, surgery today are highly successful !! I don't know all of the terms you have mentioned above however i do recognise some terms:
ischemia - means stroke and by the sounds of it the results show your husband is not at risk of stroke
arrhythmia - means heart irregularity such as a heart murmur
his maximum heart rate is quite high at 140bpm and may suggest his heart is working harder than necessary meaning it could wear out sooner - a healthier lifestyle would correct this
A heart cath test is a procedure carried out under general anaesthetic and takes approx two to three hours to complete. The test involves inserting a small plastic tube (catherter) up through a vein or artery (often in the groin or abdomen) until it reaches the heart, before injecting a dye through the tube so doctors are able to see the blood more clearly. Don't worry this dye is perfectly harmless! The purpose of this test is to measure the amount of oxygen and pressure inside the heart and the major blood vessels as low or high pressure will indicate specific heart conditions which may be present.
Transmural means affecting the entire wall of the organ
Perfusion relates to the delivery of blood to body tissues therefore i assume that a transmural perfusion defect means blood is not being delivered correctly to much of the heart perhaps because of clogging of the arteries which is probably what the heart cath test is going to establish.
Distal essentially means distant and therefore suggests a blood vessel which is attached to the heart but not part of the heart
Inferior (in this sense) means smaller than other blood vessels
Hypokinesis means abnormally slow movement which may be leading to Attentuation which means a reduction in amplitude (sound) and intensity (feeling) within the heart i would imagine
Prior infarction essentially means the death of part of the heart tissue perhaps from a previous heart attack, angina or even chest pains which were never examined. The infarction could be what is causing the heart problems.
Unfortunately i am unable to define any more of the terms however i would assume from your husband's results that his heart pumps blood too slowly hence why it needs to work extra hard when exercising and clogging of the arteries may have started to form - i would suggest simple exercises and better dietary habits to improve blood flow and prevent any future heart problems such as angina. In addition, try to help your husband reduce his stress levels as this will not be helping the situation.
Good Luck! And if you are still unsure DO NOT be afraid to ask your husband's doctor exactly what these terms mean - a good doctor would ensure their patient is fully aware of their condition and treatment and as a consumer of their services you are fully entitled and well within your rights to ask. looks as though many of the terms explained to you in above answers.
from what you've written it doesn't sound very serious. mild inferior wall hypokinesis means that the inferior wall of the left ventricle is not working as well as it might, but the word mild in front is comforting.
ejection fraction, EF, simply put, is how well your heart is pumping, an EF of 50 % is OK, although a bit reduced (normal usually 60-70%)
8 minutes of bruce protocol is OK, it would have been better to get heart rate higher than 80%, however normal BP and no symptoms are a good sign. no arrhythmias and no sign of ischaemia is telling you that there were no significant ECG changes to suggest coronary artery disease.
the cardiac catheter test - angiography is the best assesment of any coronary artery disease. it is nothing to be worried about :-) a very simple procedure where a radio opaque dye is injected briefly into the cornary arteries where they can then be mapped using x-ray.
you must discuss these concerns with your doctor. what you have mentioned does not sound to bad (we see alot worse every day), but your doctor is the best person to answer your questions, and let you know about the risks involved.
no-one is going to able to give you any specific answers to your situation over an internet question/answer, as each pt is different and your doctor will need to take lots of other factors into consideration. so take what is said above for what it is, a general idea of things. The Heart Catheterization or Angiogram, seems like is exactly what he needs.
From what you say about the tests he has had, there is an indication that he may have at least one of his coronary vessels occluded (narrowed or closed off).
A CT coronary angiogram is also helpful, but in this case, and if he has any chest pain, conventional angiogram is perhaps the best option. This Patient Guide is written for the loved ones of heart patients who are dealing with the short-term stress that comes with a test, procedure or recent diagnosis of heart disease. It explains why support is so important to a loved one with heart disease. It also offers practical strategies on how to support a loved one while also taking care of yourself. |
