adenosine stress test results

Hoping someone can explain these findings in plain English! Have been having sob and chest tightness on exertion, had 2nd biventricular pm implanted 1/22/09 due to battery. (I have a complete LBBB...) symptoms continue... Had echo, results good! EF 60%. Had adenosine Stress Test and the findings were as follows:
perfusion images:
Post pharmacologic stress images reveal a small to moderate perfusion defect of the anteroseptal wall. On the resting images there is partially improved profusion of this wall.
Conclusions:
The myoview scan shows a fixed defect of the anteroseptal wall. There is also small reversible defect of the anteroseptal wall. This lateral defect could be due to myocardium at risk.
Both anteroseptal defects could also be secondary to the patient’s paced rhythm.
My dr tends to poo poo things and is not good at explaining... especially on the phone! He says it could be a false positive due to pacing... But has no explanation for symptoms. says the only way to be sure is to have a cath. and he can refer me to another DR (he’s an arrhythmia specialist guy,) I have my 4 month checkup 5/27 and he said we can talk about it then, but I am feeling anxious about what this all means, how often do false positives happen, how does one decide if a cath is needed.... what is myocardium at risk... lots of questions... any input/information would be greatly appreciated

2 Comments

SOB & Chest Tightness

by BOB 1 - 2009-05-15 06:05:12

Sob and/or chest tightness on exertion frequently go with a partially blocked artery that is supplying blood to the heart. A totally blocked artery can also cause these symptoms but total blockage runs a high risk of causing a heart attack. My suggestion is have the cauterization to see if you have any blockage. My sob and chest pain problems were solved during a cath during which they implanted a stent. So far as I know a cath is the surest way to find out if you have any heart blockage problems. If you have haven't had the cath procedure, it takes about 20 to 40 minutes and getting the stent will add about 10 min and does not increase the discomfort from the cath.

The test results you report indicate you may need a stent.

I work in cardiology,

by Angelie - 2009-05-16 07:05:33

but by no means am I a doctor. Your adenosine stress test results do suggest ischemia (areas in your heart tissue that are not getting proper blood flow). There are flase positives, and I have often seen stress test results not correlate with cardiac cath results.
If you are continuing to have symptoms it is very important that you get these symptoms investigated as they very well may be caused by the claims of the adenosine stress test.
Cardiac caths have risks as do any procedure, but are very common and done in about 20 minutes.

I'd rather know for sure that it was a false positive stress test than to continue on living with symptoms and being at risk for further heart damage. Anyone with continued chest pain/SOB needs to get medical attention.

Good luck,
Angelie

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