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Doctor insights on: Apical Ischemia Stress Test

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My nuclear images suggest apical septal ischemia.

My nuclear images suggest apical septal ischemia.

Ischemia...: Most hearts have physiologic apical thinning which can sometimes be misinterpreted on nuclear stress test images. In addition, stress test images in patients with left bundle branch block can appear as septal ischemia if exercise stress is done rather than pharmacologic. The fact that both the apex and septum are involved in your case make it more likely to be real ischemia probably in lad. ...Read more

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Dr. Heidi Fowler
3,149 doctors shared insights

Stress (Definition)

Stress affects most people in some way. Acute (sudden, short-term) stress leads to rapid changes throughout the body. Almost all body systems (the heart and blood vessels, immune system, lungs, digestive system, sensory organs, and brain) gear up to meet perceived danger. These stress responses could prove beneficial in a critical, life-or-death situation. Over time, however, repeated stressful situations put a strain on the body that may contribute to physical and psychological problems. Chronic (long-term) stress can have real health consequences and should be addressed like any other health concern. Fortunately, research is showing that lifestyle changes and stress-reduction techniques can help people learn ...Read more


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Nuclear stress test showed large reversible ischemic defect in apical portions of anteroseptal wall. What does reversible mean?

Nuclear stress test showed large reversible ischemic defect in apical portions of anteroseptal wall.  What does reversible mean?

Blood Flow: The purpose of a stress test is to see if there any changes in circulation when your heart is put under some type of stress, usually exercise. Reversible in this case means that under stress, there is a portion of the heart that is not getting adequate blood flow. At rest, this blood flow returns. This can be a sign of a partially blocked coronary blood vessel. ...Read more

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INTERPRETATION ABNORMAL STRESS ECHOCARDIOGRAM INFERIOR WALL HYPOKINESIS WITH STRESS?

INTERPRETATION
ABNORMAL STRESS ECHOCARDIOGRAM
INFERIOR WALL HYPOKINESIS WITH STRESS?

Abnormal stress test: Stress induced wall motion abnormality is concerning for significant narrowing of the coronary artery which feeds the inferior wall of the heart. This is most commonly the right coronary artery. ...Read more

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Stress test stated moderate to severe ischemia anterior/apical. Heart cath says stress test false p,no blocks,but mild elevated EDP/LBBB. Is this causing dyspnea and exercise intolerance? Help?

Stress test stated moderate to severe ischemia anterior/apical.  Heart cath says stress test false p,no blocks,but mild elevated EDP/LBBB.  Is this causing dyspnea and exercise intolerance?  Help?

Yes: Elevated EDP indicates left ventricular dysfunction. You did not report what your ejection fraction (EF) is - it's crucial. Your EDP may be elevated from systolic and/or diastolic dysfunction. Moreover, LBBB causes dys-synchrony which further compromises LV function. Both abnormalities you list will result in impaired functional capacity manifested as exercise intolerance. ...Read more

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Stressechoresults: abn stress ECG at 9.1mets, normal exercise stress echo with no evidence of stress induced myocardial ischemia. What does this mean?

Stressechoresults: abn stress ECG at 9.1mets, normal exercise stress echo with no evidence of stress induced myocardial ischemia. What does this mean?

Probably normal: The ECG is accurate about 70-80% of the time in diagnosing cad. Adding stress echo or nuclear imaging improves accuracy to above 90% when patient reaches his or her target rate. ...Read more

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Spect images demonstrate inferior and apical reversibility from my nuclear stress test. Is a cardiac catherization must be done?

Spect images demonstrate inferior and apical reversibility from my nuclear stress test. Is a cardiac catherization must be done?

Not enough data...: Inferior ; apical reversibility means there is some ischemia in those regions. Without seeing the images it is difficult to tell how much. If there is very mild ischemia, some cardiologists may decide to do medical management (only medicines). If there is any significant amount of ischemia, cardiac catheterization is usually done. Again, it depends on the clinical scenario..Not enough data. ...Read more

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What does a positive stress test for pro-vocable mayocardial ischemia mean?

Blockage: It means that when your heart needs it, your arteries are incapable of delivering blood evenly and sufficiently to all of the heart muscle. This often means blockages in the heart arteries. Your cardiologist can tell you more. ...Read more

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Nuclear stress test and cardiac coronary CT angiogram, which do you recommend?

Nuclear stress test and cardiac coronary CT angiogram, which do you recommend?

Depends on situation: Nuclear stress test involves looking at perfusion of heart for defective areas representing coronary artery disease looking for areas of permanent damage versus areas that are reversible possible related to area of coronary narrowing. Coronary ct angiogram looks at anatomy of coronary arteries looking for areas of narrowing and blockage.Answer depends on information physician needs and insurance. ...Read more

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Could sestamibi nuclear stress test only evaluates left ventricular function?

Could sestamibi nuclear stress test only evaluates left ventricular function?

NO: Nuclear stress test are done to evaluate coronary circulation/ blockages/CAD. As lagniappe they provide info re LV function. However, there are less expensive and invasive test that evaluate LV function just as well or better, like echocardiography ...Read more

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What's provocable ischemia?

What's provocable ischemia?

Stress test: Stress tests with exercise or drugs are used to provoke ischemia, to uncover insufficient blood flow to the heart muscle. ...Read more

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Stress test stated moderate to severe ischemia anterior/apical. Heart cath says stress test false p,no blocks,but mild elevated EDP/LBBB. EF 55%. Doc says nothing to worry about no restirctions. Y?

Yes and no: EF of 55% is normal. Your breathing issues are due to diastolic dysfunction, dys-synchrony, and (by inference as there are no direct tests) small vessel CAD. You're not at risk of a classical heart attack (MI). There are no restrictions. I would vigorously treat blood pressure with an ACE inhibitor, and urge you to use a statin regardless of cholesterol level, and take 81 mg of aspirin daily. ...Read more

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I have had regular stress test. Nuclear stress test echocardiogram and heart catherization. All normal what's chance missed blockage or pulm htn?

I have had regular stress test. Nuclear stress test echocardiogram and heart catherization. All normal what's chance missed blockage or pulm htn?

Zero: There's no chance for blockage. If your pulmonary artery pressure was reported on your echo, than there's no chance that's been missed either. ...Read more

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My stress test results read " positive exercise stress test for ischemia by EKG criteria. What does that mean?

My stress test results read " positive exercise stress test for ischemia by EKG criteria. What does that mean?

This means that the: EKG portion of your stress test had changes in the waveforms that have been known to be associated with blockages of the coronary arteries. Unfortunately, greater than 15% of the time this is inaccurate in women. Less than 5% of the time in men. This is why we always do stress testing in women along with nuclear imaging. If the nuclear imaging is negative then the EKG changes are FALSE positive. ...Read more

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I am 65 yrs old and my test show mild anterior apical ischemia EF 76% Stress test abnormal for mild ischemia .

Clinical correlation: Deciding best treatment option for you really depends on your symptoms...in other words, why did you have the stress test? Chest pain? Shortness of breath, etc? Second, treatment ought to be guided by risk/benefit analysis of intervention vs medical treatment. You need to have a candid discussion with a qualified cardiologist to ascertain best next step, and intervention, if any. ...Read more

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If i had inferior ischemia... Stress test & echo would've showed something right?

If i had inferior ischemia... Stress test & echo would've showed something right?

Presumably.: A negative nuclear or chemical stress test should rule out ischemia with 95% confidence. Not 100% confidence, 95%. There's always the possibility for false negative results - if clinical suspicion is really high and the test is negative, more testing may still be in order to really be sure. Echo not reliable enough unless damage to the heart has already occurred. ...Read more

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I am 65 yrs old and my test show mild anterior apical ischemia EF 76% Stress test abnormal for mild ischemia .

Clinical correlation: Deciding best treatment option for you really depends on your symptoms...in other words, why did you have the stress test? Chest pain? Shortness of breath, etc? Second, treatment ought to be guided by risk/benefit analysis of intervention vs medical treatment. You need to have a candid discussion with a qualified cardiologist to ascertain best next step, and intervention, if any. ...Read more

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Recent stress test shows mild ischemia anterobasally and distal apical laterally. What does it mean exactly?

Recent stress test shows mild ischemia anterobasally and distal apical laterally. What does it mean exactly?

Arterial blockage.: Ischemia in areas of the heart, as you have related, infers that the arteries that feed these parts of the heart are narrowed such that blood flow through them reduces with exertion. It means these areas of the heart are vulnerable and further testing is needed and intervention may be necessary. ...Read more

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I had a stress test done and the results were mild ischemia in the basal septum. Apical thinning. Lvef of 75%. Should i be concerned?

I had a stress test done and the results were mild ischemia in the basal septum. Apical thinning. Lvef of 75%.  Should i be concerned?

Abnormal Stress Test: This test suggests abnormal blood supply to the heart itself and requires follow up with your cardiologist and additional testing at the minimum. ...Read more

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Results of a stress test it came back with a v small apical infarction with some peri-infarct ischemia noted what does that mean?

Results of a stress test it came back with a v small apical infarction with some peri-infarct ischemia noted what does that mean?

Question? Consult!: These little boxes are not good for answering specific patient case problems. Consider a cardiology consultation here on HealthTap. The kind of consult where you ask for help within the next 24 hours works particularly well for a complex case because it enables emailing back and forth with the details. ...Read more

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Stress test stated moderate to severe ischemia anterior/apical. Heart cath says stress test false p,no blocks,but mild elevated EDP/LBBB. EF 55%. Doc says nothing to worry about no restirctions. Y?

Yes and no: EF of 55% is normal. Your breathing issues are due to diastolic dysfunction, dys-synchrony, and (by inference as there are no direct tests) small vessel CAD. You're not at risk of a classical heart attack (MI). There are no restrictions. I would vigorously treat blood pressure with an ACE inhibitor, and urge you to use a statin regardless of cholesterol level, and take 81 mg of aspirin daily. ...Read more

See 1 more doctor answer
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Stress test stated moderate to severe ischemia anterior/apical. Heart cath says stress test false p,no blocks,but mild elevated EDP/LBBB. Is this causing dyspnea and exercise intolerance? Help?

Yes: Elevated EDP indicates left ventricular dysfunction. You did not report what your ejection fraction (EF) is - it's crucial. Your EDP may be elevated from systolic and/or diastolic dysfunction. Moreover, LBBB causes dys-synchrony which further compromises LV function. Both abnormalities you list will result in impaired functional capacity manifested as exercise intolerance. ...Read more

See 1 more doctor answer
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If i had inferior ischemia... Stress test & echo would've showed something right?

Presumably.: A negative nuclear or chemical stress test should rule out ischemia with 95% confidence. Not 100% confidence, 95%. There's always the possibility for false negative results - if clinical suspicion is really high and the test is negative, more testing may still be in order to really be sure. Echo not reliable enough unless damage to the heart has already occurred. ...Read more

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I had a stress test yesterday. the final impression is ' stress mildly positive for ischemia at adequate workload " pl explain?

I had a stress test yesterday. the final impression is ' stress mildly positive for ischemia at adequate workload " pl explain?

Positive: This means that they did see signs of ekg changes when you reached a certain level of exertion. This would warrant further evaluation with imaging stress test or angiography-depending on cardiologist's choice. ...Read more

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So i had stress test done it ame back ok but they said i had reversible ischemia what's that mean am i gonna die? And had 10% positives in the test

So i had stress test done it ame back ok but they said i had reversible ischemia what's that mean am i gonna die? And had 10% positives in the test

Coronary angiogram: Reversible ischemia means that when you exercise part of heart muscle is deprived of blood supply. You are not going to die, but should consult with a cardiologist to see if you need coronary angiogram. Your heart should be at resting stage. Avoid any exercise until you have the work up done. Stress test can be sometime wrong. At age 31 i dont expect you to have coronary artery disease. ...Read more

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I had a nuc stress test and dr. Told me it was negative, but i was recently declined for insurance due to mild ischemia. Is test neg? What should I do

I had a nuc stress test and dr. Told me it was negative, but i was recently declined for insurance due to mild ischemia. Is test neg? What should I do

May be artifact: Get full report from test. Some minor fixed defects are often attributed to artifact, and have no clinical significance. Check with your doc, and you may be able to challenge the insurance co decision. ...Read more

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Whats the best thing to do because I have an ischemia? I undergo also a stress test, doc. Told me its normal

Whats the best thing to do because I have an ischemia? I undergo also a stress test, doc. Told me its normal

Trust or 2nd opinion: Follow your doctors advice. If he feels there is no evidence of myocardial ischemia, and that no further testing is warranted, then either trust what he tells you or seek a second opinion. You have every right to get a second opinion if you wish, and if the 2nd opinion concurs with the first, you should not worry. ...Read more

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Very mild reversible ischemia my stress test shows there is very mild ischemia in the anterior wall in the LAD territory.What is that mean?

Reduced blood supply: Ischemia means reduced blood supply to a part or muscle. The lad refers to one wall of the heart. This means you should follow up with your doctor or a cardiologist. You are at risk for heart disease, but it doesn't tell you how great is the risk. ...Read more

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Very mild reversible ischemia my stress test shows there is very mild ischemia in the anterior wall in the LAD territory.What does that mean?

Blood flow: Reversible ischemia means that an area of your heart muscle is not getting adequate blood flow (at times) but then the blood flow "catches up" (i.e. Reversible). The lad is the left anterior descending coronary artery - it's an important blood vessel. The lad may have a blockage - would recommend seeing your cardiologist. ...Read more

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Sir can you suggest me what's the best thing to do with regards with ischemia? I undergo stress test the doctor told me its ok..(normal)

Trust or 2nd opinion: Follow your doctors advice. If he feels there is no evidence of myocardial ischemia, and that no further testing is warranted, then either trust what he tells you or seek a second opinion. You have every right to get a second opinion if you wish, and if the 2nd opinion concurs with the first, you should not worry. ...Read more

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Normal nuclear stress test recently. Doc said I have "no ischemia" how can this be known since blockages of 65-70% are needed it trigger positiv test?

No ischemia: No ischemia does not mean that there are no blockages. Ischemia is caused by inadequate blood flow to the heart muscle leading to an adequate oxygen supply. Less significant narrowing of blood vessels may not lead to impairment of blood flow and therefore may not cause ischemia. ...Read more

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Does " no significant ischemia" mean their is no ischemia? This showed during stress test and found previous mi?

Maybe not: Normally if there is no ischemia, the report will say that. The statement no significant ischemia" may mean that there is a small area of posible ischemia - usually not threatening to you. Ask your doc to clarify this. ...Read more

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My stress test results were read to me over the phone by a nurse. What does large anterior reversible midlateral ischemia mean.

My stress test results were read to me over the phone by a nurse.  What does large anterior reversible midlateral ischemia mean.

Heart of the matter: Please speak with your doctor himself or herself, so you can get individualized answers. The nurse's report sounds like you have signs of reversible damage to the front part of your heart muscle, from not enough oxygenated blood nourishing it. Your doctor can share his/her interpretations of these results, & make suggestions based on your whole evaluation. ...Read more

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Stress test shows small perfusion defect along lateral wall which appears reverisable and is suspicious of ischemia 2. Mild hypothesis prior mi ?

Stress test shows small perfusion defect along lateral wall which appears reverisable and is suspicious of ischemia 2. Mild hypothesis prior mi 
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Imaging: Vasospastic angina (coronary spasm) is associated with normal coronaries,. In the presence of significant physical, emotional or chemical (drug abuse) stress, chest pain is experienced.. Nitroglycerin, calcium channel blockers, anti-anxiety medication relaxation therapy help. Also worth trying omega oils (eg from www. Cardiamin.com using discount code CMC), magnesium and vitamin D supplements. ...Read more

Dr. Herman Hammerstead
3 doctors shared insights

Stress Test (Definition)

A stress test is a cardiac test which can include walking on a treadmill and monitoring your heart while you are walking. They can also inject you with a nuclear material and do a more comprehensive scan on your heart to check for blockage. They can also do a chemical stress test which omits the need to ...Read more


Dr. Cynthia Thaik
1,920 doctors shared insights

Ischemia (Definition)

Used to describe inadequate blood flow and oxygen delivery to an extremity,an organ ,or brain which ...Read more