Perfusion Scan

Hi everyone.

I got my PM in July 2010 For A-Fib.  In September my EP sent me for a Myocardial Perfusion Scan.  The study was interpreted as subjectively positive and objectively equivocal.
The resting ejection fraction was 64%.  Spect images demonstrated no definite evidence of reversible myocardial ischemia.  When my EP read the report he said my heart was OK, but I see now my Doctor has put under medical conditions "Ischamic Heart Disease". Can somebody please explain to me why my doctor would put that down from that scan report?

Thanks,

Roy

3 Comments

The doc has CBS ( Check Box Syndrme)

by ElectricFrank - 2011-01-15 10:01:46

Seriously, there is a tendency for the doc to check as many diagnosis's as he/she can remotely be justified. One reason for this is a CYA reaction. The other is that it justifies more treatments and $$$.

My original diagnosis included Heart Block, SSS, Variant Angina, and a couple more I would have to look up. The SSS was not justified from my ecg. The Variant Angina was the result of my honest answer about chest pain, but ignored my additional comment that it was muscle pain from some heavy yard work. The block was the real reason for the pacer. Over 6 yrs later I am still battling to get the SSS and Variant Angina off my medical records. One approach that seems to be getting results is that I have send letters to the hospital and each doctor that I do not release any part of my records that contains these diagnosis.

This is one of my concerns about the new universal electronic medical records. Once an error is recorded we will live with it the rest of our lives.

frank

Continued

by agelbert - 2011-01-16 09:01:04

So how can somebody have Ischemic Heart Disease and still have a high ejection fraction?
It seems that the left ventricle, the workhorse of the heart because, unlike the right ventricle which pumps to the nearby lungs, has to pump to you toes, can be compressing okay (good ejection fraction) but still have problems during relaxation (it doesn't completely fill up). They call that diastolic heart failure. There is reduced blood flow (ischemia) because, even though the pumping is fine, there is less than the normal amount of blood to pump.

One of the tools used to find out if diastolic heart failure exists is the measurement of ANP and BNP hormone levels in you blood. These hormones are produced as a response to heart muscle stretch (too much, too little or just right) in the atria (ANP) and in the ventricles (BNP).

What they do normally is lower blood pressure through biochemical dances.
I
recommend you get a copy of your lab report and find out what your ANP and BNP levels are. If they are in the normal range, I would ask the doctor why he thinks you have Ischemic Heart Disease when your atrial natriuretic peptide (ANP) and your Brain natriuretic peptide (BNP) levels are normal.
Note: BNP is called Brain NP because, although it is made in our ventricles, it was first discovered in pig brains.
If a blood test to determine these hormone levels has not been done, I would request one.
I hope this helps.

Ischemic Heart Disease

by agelbert - 2011-01-16 09:01:18

Hi Roys,
I read your post yesterday and it really left me scratching my head. I'm with Frank on all that job security stuff the doctors like to engage in. I know they have a tough job but sometimes it seems they want to cover too many bases at once.
Ischemia literally means lack of blood flow. A normal (actually it's great!) ejection fraction like yours doesn't seem to fit with a diagnosis of ischemia.
I'll be right back to continue this post.

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