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High Blood Pressure

Nuclear stress test- what do these results

10/16/2007

Question:

Nuclear stress test....what do these result mean…..

A little about me I am 58 year old male grossly overweight at 270 lbs. I have been taking blood pressure meds since mid 20”s normal blood pressure readings are in normal rage of 120/78 to 138/ 90

1 Baseline EKG shows normal Sinus rhythm 2 the patient exercised for 7 minutes and 15 seconds on a standard Bruce protocol with a rise heart rate from 72 to 150 and a rise in blood pressure of 140/96 to 220/80 the test was terminated secondary to achieving target heart rate 3 there was no significant ST or T wave changes in response to exercise Impression Negative graded exercise test to work load of 10.2 METs, a heart rate of 150, 92 percent of predicted maximum

Myocardial Spect scan with cardiac wall motion and ejection Fraction The study was done according to Bruce Protocol with patient reaching 92 percent of predicted maximum heart rate. the patient received 10.4 mCi of Technetium-99m Myoview for the stress examination and 30 mCi for the resting Finding: There is normal Radionuclide uptake thought out the left Ventricle in both stress and resting studies. There is no reversible defect. There is grossly normal cardiac wall motion. Ejection fraction is 61

Answer:

Your exercise stress test is normal.  You achieved a heart rate that is close to the target, which is around 160 for a person of your age.  Your EKG did not show any sign of coronary artery disease.  Coronary artery disease can cause the blood flow to the heart to become inadequate with exercise.  This is seen in elevations of the ST-T segment on EKG.  You had no significant ST or T wave changes.  This was confirmed by the nuclear scan.  The scan shows the pattern of blood flow through the heart muscle, and can detect coronary artery disease.  Again, you flow pattern was normal.

The stress test also gives a picture of your heart's ability to pump blood (workload).  A workload of 10.2 MET (metabolic equivalents) means that your heart performs normally.  The ejection fraction is a measure of the amount of blood that remains in the left ventricle after it has contracted.  A normal ejection fraction is 0.6 or greater.

In summary, your stress test shows that you have no significant coronary artery disease, and that your heart muscle can work adequately.  However, given that you are only 58 years old, you should lose weight and begin a graduated exercise program.  Your weight is a significant risk factor for developing diabetes, hypertension and/or heart disease later in life.

If you have further questions, you should ask your doctor that ordered the stress test, since he or she should know your case well.

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Response by:

Max C Reif, MD Max C Reif, MD
Professor of Medicine
Director of Hypertension Section
College of Medicine
University of Cincinnati