mild Inferior Ischemia

[Kardiohelp]

I had recently my Stress test and ECHO done and ECHO was normail I could also get to my 83% of heart rate in 13.5 mins. but however the isotop test showed the following,
Abnormal SPECT perfusion study suggestive of a medium region of mild ingerior ischemia with a summed difference score of 3
Normal left venticular systolic funtion with an EF of 53%.
the basilar two thirds of the inferior wall is equivocal for ischemia. the remaining wall segments demonstrate normal perfusion.

I am 45 yrs of age and normally do a spinning call or tread mill for around an hour every other day.

what could this mean and do i need to see a cardiologist immediately

thank you

[kenkeith]

For some insight on Bruce portocol:

An exercise capacity of 5 METs or less is associated with a poor prognosis in subjects less than 65 years old. An exercise capacity of 13 METs indicates a good prognosis despite abnormal exercise test responses.

Metabolic Equivalents (METs) for Maximum Exercise

1 MET = resting
2 METs = level walking at 2 mph
4 METs = level walking at 4 mph
5 METs = poor prognosis; usual limit immediately after MI; peak cost of basic activities of daily living
10 METs = prognosis with medical therapy as good as coronary artery bypass surgery
13 METs = excellent prognosis regardless of other exercise responses
18 METs = elite endurance athletes
20 METs = world class athletes•Bronchospasm

•Severe chest pain associated with ECG changes (>2 mm ST depression or any ST elevation in a non–Q-wave lead):

I can't comment on your doctor's recommendation for a cath.  You seem to have a strong cardiovascular system!!!  

[Kardiohelp]

I had gone for a physical when my doctor suggested for a stress test and ECHO just to make sure i am in good health. the results are as under
Abnormal Stress ECG which si positive for ischemia however the specificity is decreased due to abnormal baseline ST changes
Abnormal SPECT perfusion study suggestive of a medium region of mild inferior ischemia with a summed difference of 3. Normal left ventericular systolic function with an EF of 53%. Based on the nucleaer data, tehn near term rish for a cardiac event is intermediate.

Also On Bruce protocal I was able to achieve an estimated work load of 14.8MET's
how big a risk is this do I need to get a cath done or should i start some kind of medication

[kenkeith]

According to the perfusion test, there may be some blockage (ischemia) to the locations indicated.  Your heart's pumping ability is good (EF...ejection fraction..the amount of blood pumped with each heartbeat.  Normal is 50 to 70%)  

Whether to see a cardiologist would depend on whether or not you have angina (chest pain), shortness of breath, etc. and you indicate you don't.  What have been your medical complaints and what are dotors trying to diagnose if you know?