What treatment for a heart blockage is best?

Dr T Ask Doctor T, Cardiac Risks, Treatment 3 Comments

Question:

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?

Answer:

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

Comments 3

  1. I have had blockage in both legs and 2 angioplasty/stent procedures each. 1st round 21 months ago followed by a 2nd round 14 months ago. Now I have blockage again that requires another round of treatments.

    Two months ago they identified blockage of the heart arteries. On the right side the blockage of the 2 main arteries was ~95% and 90% and on the left side 70% and 70%.

    They attempted to stent the left side but were unable to insert the stent so only ballooned.

    Where is the best place to seek treatment for my condition?

  2. This is what my Lexiscan said: No evidence of ischemia on Lexiscan ECG. Chest pain did not occur. Overall LV systolic function is normal without regional wall motion abnormalities. Stress LV EF: 75%. There is infero-apical fixed defect suggestive of diaphragmatic attenuation with no reversible defects. LV dilation was normal.

    I don’t see the doctor for 2 more weeks as there are other test we are waiting for, ex: the results of the 2 week monitor I wore. should I be concerned?

  3. Hi, I had stents (2) end on end in one of my arteries. I had 70% blockage. I also have 50% blockage in two other arteries which have not gotten stents. I was told I had a “strong heart”? My question: should I be concern I have a likely chance of dying from a heart attack. I’m 73 years young. My BMI is very good. I eat lots of fruit and veggies? Thank you.

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