Patient's Query
Hi doctor,
I would like to consult about my stress echo report. I am a 57-year-old with diabetes and on medication, asymptomatic, and went for screening due to family history and comorbidities of diabetes.
Stress ECG:
Abnormal ST-segment depression (ischemia).
Abnormal ST-segment elevation (ischemia).
No arrhythmias.
Stress protocol:
Bruce protocol.
Exercise duration: 5:09 minutes.
Max workload: 7.0 METS.
Max heart rate: 142 bpm (87 % predicted).
Heart rate response: Normal.
BP: 116/55 mmHg at rest. 85/45 mmHg with exercise (hypotensive response).
Symptoms: Chest tightness (2/10), resolved spontaneously.
Functional capacity: Moderate workload.
Impression: Positive stress test – suggestive of ischemia.
Resting echocardiography:
LV size: Normal.
LV systolic function: Normal (LVEF 60 to 65 %).
Regional wall motion: No abnormalities.
Post-stress echocardiography:
LV systolic function: Decreased with stress.
Stress-induced wall motion abnormalities are present.
Hypokinetic segments:
Basal anterior.
Basal inferolateral.
Mid anterior.
Mid inferolateral.
Apical anterior.
Apical inferior.
Apical lateral.
Apex.
Dyskinetic segments:
Mid anteroseptal.
Mid anterolateral.
Apical septal.
Remaining segments: Normal.
Final impression:
Positive stress echocardiogram.
Stress-induced wall motion abnormalities.
Reduced LV function post-exercise.
Hypotensive response.
Findings consistent with exercise-induced myocardial ischemia
Please guide.
Thank you.
Hi,
Welcome to icliniq.com.
I read your query and understand your concerns.
Thank you for sharing your stress echocardiogram report with us. I have read the report in detail. The indication for the test was a high calcium score of more than 400, which in itself is an indicator of the presence of coronary artery disease (CAD).
Your stress test was positive, which means it showed features highly suggestive of CAD. These features include the following: You only achieved a moderate workload, and, although you reached your target heart rate, you experienced chest discomfort. This was associated with diffuse, high-risk ECG (electrocardiogram) changes.
Additionally, you had a drop in blood pressure with exercise, which is a high-risk feature, as blood pressure should elevate during exercise. Finally, your stress echocardiogram showed multiple territorial wall motion abnormalities, meaning some segments showed poor contraction while others showed no contraction at peak stress, which was associated with a drop in heart function.
All the above indicate the presence of CAD and would require optimized medical therapy and angiography with the intent of revascularization, which means the correction of CAD as per the angiogram (either through stenting or coronary artery bypass grafting).
I would suggest consulting an interventional cardiologist as soon as possible to start planning your treatment and definitive management. Once revascularization is completed, the chances of having any major adverse cardiac events would be decreased, and you would also experience symptomatic benefits.
I hope this information is helpful.
Please do not hesitate to contact me if you need to know anything else; I would be happy to answer.
Thank you.
Was this conversation helpful?
Answered byDr. Wajahat
Medically reviewed byiCliniq medical review team
Same symptoms don't mean you have the same problem. Consult a doctor now!
Disclaimer: No content published on this website is intended to be a substitute for professional medical diagnosis, advice or treatment by a trained physician. Seek advice from your physician or other qualified healthcare providers with questions you may have regarding your symptoms and medical condition for a complete medical diagnosis. Do not delay or disregard seeking professional medical advice because of something you have read on this website. Read our Editorial Process to know how we create content for health articles and queries.