Would anyone be willing to give their 2 cents about the following:

Abnormal mycordial perfusion images. All fixed anterior wall defect, most likely due to scar from remote myocardial infarction. No symptoms were noted and there were nonspecific EKG changes.
Conclusion:
1. Normal LV size
2. EF 69%
3. Small fixed anterior defect

This is my father's nuclear stress test report that was performed after a routine stress test revealed changes on his EKG. I have not seen his EKG so I do not know exactly what changes were seen. His history quickly includes HTN (currently managed with HCTZ and Atenolol), Hyperlipidemia (managed with Simvastatin), 4-vessel angioplasty in 1994, silent MI, and a 5-vessel CABG (including LAD and some posterior vessels) 2 years ago. He is not overweight, not diabetic, and has no history of smoking, but does have a strong family history of heart disease. Just curious exactly what I should take away from the "fixed anterior defect." I am a second year student and have not started my rotations yet, so any help you are willing to give would be much appreciated. Thank you in advance.

It is hard to say but the fixed anterior defect is probably the silent MI that he had. Being fixed, this is just scar and not suggestive that he has any new areas of ischemia. If he had new lesions causing ischemia, you'd see the report mention areas of reversibility that follow a vascular distribution.

It is hard to say what the significance of the non-specific ekg changes are. Usually this refers to the T waves, maybe some slight upsloping or flattening. If there was something specific about them, they would have mentioned it in their interpretation... The images are the most specific and those sound relatively normal.

Would anyone be willing to give their 2 cents about the following:

Abnormal mycordial perfusion images. All fixed anterior wall defect, most likely due to scar from remote myocardial infarction. No symptoms were noted and there were nonspecific EKG changes.
Conclusion:
1. Normal LV size
2. EF 69%
3. Small fixed anterior defect

This is my father's nuclear stress test report that was performed after a routine stress test revealed changes on his EKG. I have not seen his EKG so I do not know exactly what changes were seen. His history quickly includes HTN (currently managed with HCTZ and Atenolol), Hyperlipidemia (managed with Simvastatin), 4-vessel angioplasty in 1994, silent MI, and a 5-vessel CABG (including LAD and some posterior vessels) 2 years ago. He is not overweight, not diabetic, and has no history of smoking, but does have a strong family history of heart disease. Just curious exactly what I should take away from the "fixed anterior defect." I am a second year student and have not started my rotations yet, so any help you are willing to give would be much appreciated. Thank you in advance.

It is hard to say but the fixed anterior defect is probably the silent MI that he had. Being fixed, this is just scar and not suggestive that he has any new areas of ischemia. If he had new lesions causing ischemia, you'd see the report mention areas of reversibility that follow a vascular distribution.

It is hard to say what the significance of the non-specific ekg changes are. Usually this refers to the T waves, maybe some slight upsloping or flattening. If there was something specific about them, they would have mentioned it in their interpretation... The images are the most specific and those sound relatively normal.


Thank you very much Lukerboy!!!