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23 January 2018 @ 10:57 pm
Nuclear scan results  
Note that any nuclear scan will see the damaged area of my heart where I had a heart attack following my 2001 bypass surgery.

"Ejection fraction is a measurement of the percentage of blood leaving your heart each time it contracts." Even after my heart attack my EF was in the high 50s but it has gradually declined and I was told that was to be expected after a heart attack and that the force of my heart beating causes further deterioration of the damaged area.

However, the difference in these two results and their conclusions is cause for alarm along with my symptoms and having just lived through one of the most stressful years of my life. The chest pain I've had, the shortness of breath and that stress level is what made me ask for the test in the first place. I have an appointment with my cardiologist in early March but I wish it were in February.

Current results:

PROTOCOL: The patient received 6.3 mCi of Tech-99 Cardiolite and was imaged in the supine position. The patient then received a 4-minute infusion of adenosine without walking. At 2 minutes into the protocol, the patient received 20.2 mCi of Tech-99 Cardiolite and at the end of the procedure was reimaged in the supine position. The total dose of adenosine infused was 80.1 mg.
Tc-99m Sestamibi also known as Cardiolite, Rest. Tc-99m Sestamibi also known as Cardiolite, Stress. The total amount of radiation that the patient received in this study is estimated at 7.84 mSv or 784 mrem.
FINDINGS:
1. Hemodynamics: The Initial heart rate was 94 bpm; the blood pressure was 142/94. The heart rate rose to 100 bpm; the blood pressure peaked at 141/86.
2. EKG Portion: The baseline EKG revealed NSR LBBB LAD.
3. Adenosine Portion: No ischemic EKG changes were observed. No significant arrhythmias were provoked. Occasional PVCs. Nonspecific ST depression during adenosine noted
4. Perfusion Portion: Revealed a large fixed anteroapical/inferoapical defect with peri infarction ischemia involving the mid anterolateral wall. The summed stress score was 30, the summed rest score was 25, and the summed difference score was 5. The TID ratio was 1.10. Gated wall motion revealed mid anteroapical/inferoapical akinesis with an estimated EF of 35%.
OVERALL CONCLUSION:
Abnormal study with large anteroapical fixed defect c/w previous MI . Small region of peri infarction ischemia mid anterolateral wall with reduced EF 35%.

vs 2015 (after which I had a stent)

1. Hemodynamics: Initial heart rate 56; blood pressure 156/92. Heart
rate rose to 77; blood pressure rose to 165/94.
2. EKG Portion: Baseline EKG revealed sinus rhythm and evidence of an
anteroseptal myocardial infarction, age indeterminate.
3. Adenosine Portion: No ischemic EKG changes were seen. No significant
arrhythmias were provoked.
4. Perfusion Portion: Revealed a large region of decreased activity
involving the mid to distal anteroapical, inferoapical, and anterolateral
walls, with what appeared to be a small region of possible peri-infarction
ischemia involving the mid anterior wall. Quantitatively the summed
stress score was 23, summed rest score 16, and summed difference score 6.
TID ratio was 0.86. Gated wall motion revealed a reduced EF of 40% with
hypokinesia involving the distal anteroapical, inferior, inferoapical, and
inferolateral walls.
OVERALL CONCLUSION:
Abnormal study demonstrating a previous anterior myocardial infarction
involving the anteroapical and inferoapical segments with what appears to
be some mild reversibility in the mid anterior wall.