Heart Cath coming up...

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perrypiratesdad

perrypiratesdad

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May 14, 2008
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Ohio
Hi all... I haven't visited the site for some time, but I do have a question. I recently had a Nuclear Exercise Stress test and my doc has recomended that I have a Heart Cath to see what exactly is going on. Can anyone help me with the following findings, as I'm not sure what they mean.

In both the stress and rest tomographic images tracer distribution is moderate perfusion defect involving the entire anterior septum, inferior septum, inferior wall, apical anterior wall, and apex.

Gated tomographic images post stress with the patient at rest demonstrate global hypokinesia with septal and apical septal dyskinesia. Left ventricular ejection fraction is 32%.
Click to expand...

Questions... what do the underlined sections above mean?
 
seems like it means that after the stress portion, parts of your heart weren't moving as expected, and some areas of the heart weren't filled with the nuclear medicine... at least according to the radiologist that viewed the images. Basically, if your heart isn't taking up the nuclear med it means that there may be a lack of blood flow to the area that didn't take it up.

In other words, it's time for a heart cath. :)

Don't worry yourself too much about it, I had a similar stress test result and the cath ended up being clean as a whistle. I think false positives happen pretty often with those tests... but woe to the person who doesn't take it seriously.
 
I'm not sure if you've ever had a cath before, but honestly I'd rather have a cath than a TEE. Piece of cake. That's not to say it is without risk. If they need to put a stent in, the risk increases... but it's still pretty darn low risk.
 
Thanks Duff... yes, I've had a cath done before, but that was 25 years ago and I think that is what scares me. That and the "what if" thoughts. I remember the intense heat feeling when they shot me up with the contrast and it scared the heck out of me.

The other thing that concerns me is my EF. With the Stress test they measured it at 32%, but just two weeks prior at my echo, it was measured at 45%. Why is there so much of a difference? I find it hard to believe that one of them is not very accurate. I mean 32% is really low when the norm is around 50%.
 
Many of us here come back and report we stressed so much in advance of cath and found we wasted a lot of energy for nothing. It was way easier than I expected and my cardiologist used an angio-seal to close the entry spot so I didn't have lay still excessively long after. I had no pain, don't even remember much of the experience as I (and most people) was given versed with other meds. I was up to all my usual activities the next day including driving.

Best wishes. Let us know how it goes.
 
perrypiratesdad said:
Thanks Duff... yes, I've had a cath done before, but that was 25 years ago and I think that is what scares me. That and the "what if" thoughts. I remember the intense heat feeling when they shot me up with the contrast and it scared the heck out of me.

The other thing that concerns me is my EF. With the Stress test they measured it at 32%, but just two weeks prior at my echo, it was measured at 45%. Why is there so much of a difference? I find it hard to believe that one of them is not very accurate. I mean 32% is really low when the norm is around 50%.
Click to expand...

It looks like the stress test said, as much blood as normal is not getting to all the parts of your heart (the muscle that make up your heart itself, not inside your heart to your lungs/body)
and the global hypokinesia pretty much means the heart isn't functioning/moving well.
Hopefully the cath will give you more answers.
 
Thanks Judy and Lyn...

So Global hypokinesia would be the entire heart having decreased movement? Could this be from the complete LBBB?

What does Dyskineses mean then? I always thought dys- was opposite or does it mean "bad" or "messed" up in this case?
 
I could guess a few things, but I really think you should call your doctor who orderred the cath and try to get answers from him or his staff. There are so many different things that could be playing a role and I would hate to make things even more confusing.
 
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Sorry your doctor wasn't more helpful
The problem is alot of the words to me at least sound scarey, so I would hate to say something that would make you worry for nothing.
How do you feel? Did you have the stress test, because you were having some kind of symptons or it was routine, just to check up on things? The reason I ask is one of the things I did find about LBBB was this http://my.clevelandclinic.org/heart/askdoctor/stress-testing-left-bundle-branch-block.aspx
Question:
I have a left bundle branch block and my doctor wants to perform a stress test. My concern is the result will not be accurate due to left bundle branch block. Is this true?


--------------------------------------------------------------------------------

Answer:
You are correct. Stress tests in the setting of complete left bundle branch block, be it echo or nuclear based, can be problematic. They are still valuable but may lead to both under and over diagnosis. The electrocardiogram portion does not help except for monitoring the heart rhythm. A treadmill stress test can be useful to monitor for symptom provocation and also for a normal vs. abnormal blood pressure response to exercise. I cannot make a recommendation as to yes or no should the pt have the stress test as I am not directly involved with their care. I do offer stress tests in patients with LBBB but make sure they are interpreted extremely carefully in the context of exercise duration, blood pressure response and presence or lack of chest discomfort"

So I don't know how your LBBB could have made your heart look worse than it really is. Especially considerring the big difference in your EF between the echo and stress test.

From what I know and I don't understand heart failure (one of those words I didn't want to use) that well. But I'm not exactly sure if global kinesis technically means the entire heart has poor function, of it is mainly is talking about the left ventricle. (like unless some one specifies the EF is a right ventricle EF, it is assumed they are talking about the left side) also There are a few things that could cause the muscles not to contract as well as "normal" I would guess IF the muscle isn't getting enough blood to it, THAT could make it not to move/contract strongly, also Justin has RBBB not Left, but I think there are a few different kinds of LBBB and what kind, and what is causing it, would probably make a difference in if it is related to the global kineses.

I think the septal dyskinesia, is instead of the septum moving toward the left ventricle when it is contracting to force the blood out, the septum is going right Which would make sense with you saying "dys" is opposite

Again, there is so much involved and I'm just going by the words on the report, which may or may not be right.

That might be why your doctor wants to see what the cath has to say, before he is explaining things well.
 
I can't help you much except to relieve your concern about the contrast dye. I have had 4 caths and had one "way back when" and had the same negative reaction to the constrast dye. My last cath was in 2004 and the improvement was remarkable. My only sensation was an almost pleasant warm feeling with the only weird side effect being that it made me feel like I had to pee. ;).
 
Wondering if you will have the option for arm or groin?
as opposed to heads or tails ;)

I asked about the option and was told good possibility of choice... Had right arm as a wee lass...am thinking arm again if possible.
 
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