What treatment for a heart blockage is best?

I have been advised by my primary physician to schedule a cardiac catherization and possible stent placement procedure after having a Nuclear Stress Test with the following "Findings:  The study quality is excellent.  There is no transient LV ischemic dilatation noted.  The left ventricular chamber dimensions are normal.  There is a mild to moderately reduced perfusion defect of moderate size in the inferoapical wall.  Study quality: fair. SPECT images demonstrate normal perfusion at rest.  The left ventricular chamber dimensions are normal.  The defect in the inferoapical segment is reversible.  The left ventricular chamber dimensions are normal.  Normal systolic function.  The calculated EF is at 60%."  And the "Impressions:  1. Ischemia: There is a mild to moderate area of ischemia in the infero-apical segment(s).  2. Stress EKG: Stress EKG Test Results - Normal.  3. There is no previous study available for comparison.  4. No evidence of infarction.” DO I NEED THIS PROCEDURE OR ARE THERE BETTER OPTIONS?  

The test proves you have insufficient blood supply to a small part of your heart, but that overall function is normal. Many patients can be treated with medications and a heart-healthy lifestyle, and a procedure such as a stent or bypass is only needed for them when there are disabling and/or progressive symptoms, or the blockage is in a dangerous location.

The blockage is likely in your right coronary artery and treatment should depend on  your symptoms and the heart muscle section at risk. You can calculate your options here.

Hope this helps,

Dr T


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