Here is the summary from the stress test:
TECHNOLOGIST STRESS SUMMARY
The patient underwent an exercise sestamibi imaging study. The patient
exercised for 10 minutes 56 seconds reaching 139 beats per minute which is
86% of the predicted maximum heart rate. This is the equivalent of 13.2
METs. The blood pressure ranged from 138/104 to 169/101. The test was
terminated secondary to fatigue. The patient had no symptoms during
stress. The patient was imaged on the CZT camera. The patient received
5.6 mCi of sestamibi IV at rest and 15 mCi of sestamibi IV at peak stress.
Now, first what is "exercise sestamibi imaging study"?
This test requires the intravenous injection of a radioactive blood flow marker followed by imaging of the heart. The test is a well-established noninvasive method of assessing coronary blood flow. The test is capable of identifying regional abnormalities in coronary artery blood flow and determining their physiological relevance to myocardial function and viability.
So, the radioactive marker (I now glow in the dark) allows the doctor to view the blood flow!
The test lasted 11 minutes & the final 2-3 minutes were "butt kickers!" Had to get my heart rate to 139! And with my beta blocker this is difficult!!! I did it, but was huffing & puffing!!! 139 is 86% of my maximum heart rate. I had no symptoms, but still had some PVC's. Good news is the most I had was 3!!
The rules have changed with my stress test. In the other tests I had, if I had 3, they stopped the test - know the person giving the test said the new rules say 10!!!! Need to ask my cardiologist about this!
Other comments were:
IMPRESSION
1. Good functional capacity with patient exercising for 10 minutes and 56
seconds on the Bruce protocol.
2. Normal hemodynamic response to exercise.
3. Patient did not have any chest pain on the treadmill.
4. No ST depressions diagnostic of ischemia were noted with exercise.
5. The patient had frequent PVCs including ventricular bigeminy,
ventricular couplets, and two 3-beat runs of nonsustained VT at peak
exercise.
6. Uniform perfusion was noted. There is no evidence of ischemia or
infarction.
7. Septum is hypokinetic, likely related to postop state. Ejection
fraction is 50%.
This added some new concepts!
What is the Bruce Protocol? According to wikipedia:
The Bruce protocol is a diagnostic test used in the evaluation of cardiac function, developed by Robert A. Bruce.
ST depressions? Again Wikipedia:
In a cardiac stress test, an ST depression of at least 1 mm after adenosine administration indicates a reversible ischaemia, while an exercise stress test requires an ST depression of at least 2 mm to significantly indicate reversible ischaemia
And ischaemia? Ischaemia is a restriction in blood supply to tissues, causing a shortage of oxygen and glucose needed for cellular metabolism (to keep tissue alive).[3] Ischemia is generally caused by problems with blood vessels, with resultant damage to or dysfunction of tissue.
Well, how about infarction?
infarction refers to tissue death (necrosis) caused by an obstruction of the tissue's blood supply, which leads to a local lack of oxygen
What is ejection fraction? This is a test that determines how well your heart pumps with each beat. Mine was 50%, Below Normal!
Overall not bad! That is the highest I had my heart rate in more than 3 years!!! After my heart surgery I have been afraid to "take it up a notch". Now these results go to my cardiologist and I meet with him in March!!
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