Heart & Cardiology/Heart test results

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Question
I am a 45 year old woman, I have extremely low blood pressure and I get constant dizzy spells and occassionally come close to blacking out as well as get extreme pressure in my chest with difficulty breathing when I am active. I also frequently have the same type of symptoms right when I wake up and they will last through out the day when this happens, it causes me to be extremely tired and makes my head kind of "foggy".  When I had a stress test done,  I was stressed pharmacologically with lexiscan as I could not handle the physical test.  The findings were, left ventricle is normal in size.  There is minimal reversibility seen in the anterior wall. The remainder of the left ventricle is well-perfused.  Trace ischemia cannot be excluded. Ejection fraction is 60%. I was also diagnosed with syncope and bradycardia.
Can you explain what any of this means, the doctor I saw did not really explain it very well and should I be concerned about being at risk for a heart attack or stroke? Also, should I get a more thorough examination?
Thanks for your help!

Answer
Eating lots of salt and drinking ots of water may help your low BP, which is causing your dizziness.  There are also medicines that help.  Mitodrine and pyridstigmine are two.  I favor Mitodrine in your case because it raises lying-down BP as well as standing BP.

Minimal reversibility means the heart did not take up as much dye during stress as without stress.  Ischemia means not enough blood supply.   This is probably a false positive and unless you have chest pain, you need do nothing about it.  Ejection fraction is the percent of the hear't blood pumped out with each beat.  Above 50% is normal.  Syncope is fainting and bradycardia is slow heart beat, less than 45 awake or 35 asleep.  Your bradycardia is part of your your low BP.  Bradycardia actually is good, predicts a long life.

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David Richardson

Expertise

Adult heart function and disease. Not very good about children lesss than 12. Hypertension is o.k. Heart rhythm a special interest.

Experience

Certified in cardiology by the American Board of Internal Medicine. Was chairman of division of cardiology at the Medical College of Virginia. Am now mostly retired.

Organizations
Fellow of American Heart Association and American College of Cardiology and member of American Physiological Society..

Publications
Circulation, American Heart Journal, Hypertension.

Education/Credentials
M.D. from Harvard Medical School. Residency training at Yale Uhniversity School of Medicine and Medical College of Virginia.

Awards and Honors
Gold Heartt Award from American Heart Association in 1995.

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