I am wondering if there is anyone out there that can tell me what is in my future. I had a stress test yesterday. The results were fixed inferoapical perfusion defect. I have prinzmetal angina, diagnosed in 10 2010. I am wondering what does this mean and do i need to have a cath done. I have been having chest tightness and SOB for the past 3 weeks.
This will need to be discussed with your doctor(s).
"I have prinzmetal angina"
Noteworthy, coronary artery spasm (CAS) is a transient constriction or a transient total closure of a coronary artery (typically, but not 100% always, occurring at rest, causing chest pain, i.e., Prinzmetal's or variant angina, and/or other symptoms), and may/can lead to a heart attack if spasms are prolonged or are of extended-duration.
Also noteworthy is that CAS may/can occur at the site of a significant blockage, or may/can occur at the site (or right near it) of a mild blockage, or where there is no visible blockage at all (coronary arteries appear to be squeaky clean).
As applicable, one is typically perplexed if/when an actual (not a false finding on a routine resting ECG/EKG or nuclear imaging) heart attack has occurred, only to have invasive cardiac cath results showing no blockage(s), or say a mild blockage in one or more coronary arteries.
Infero = inferior (lower area)
Apical = apex (bottom tip)
The two main concerns regarding a nuclear stress test involves an actual (not an artifact, a false image indicating so) narrowing or scarring, that is, the findings of reversible (ischemia) or non-reversible (FIXED, permanent, scar tissue, infarct, heart attack) perfusion (blood flow) defects.
After stress myocardial perfusion imaging (stress MPI, gated-SPECT scan with Cardiolite or Myoview), the patient's cardiologist may take some time to study the results of the scan before discussing the findings.
One can typically expect one of the following four results -
No perfusion defect after exercise or at rest
The heart muscle and blood flow to the heart muscle appear to be normal.
Perfusion defect after exercise, but not at rest (reversible defect)
There is some degree of blockage in a coronary artery that interferes with the blood flow to the heart muscle. In someone with significant heart disease, when the heart works hard, it does not get the blood supply and oxygen that it needs (a supply 'n demand mismatch).
At rest, however, the blood adequately reaches these areas or regions; ANTERIOR/ANTERO (front wall), INFERIOR/INFERO (lower area/lower wall area), POSTERIOR/POSTERO (back wall), SEPTAL/Septum (dividing wall), APICAL/APEX (bottom tip of the heart) and LATERAL (side wall).
The heart muscle has living cells/tissue in these areas. This indicates that clearing the blockage in the affected artery will be of benefit.
Perfusion defect AFTER exercise AND at rest (FIXED defect)
There is one or more totally blocked coronary arteries and one has had damage done to the heart muscle because of a heart attack.
There is an area/areas of the heart muscle that has become scar tissue (scarring, scarred) because of the heart attack.
This area would not be able to make functional use of any oxygen even if blood flow to that area of the heart were completely restored.
Combined reversible and fixed defects
It is common for individuals with coronary artery disease to have different degrees of blockages in different arteries.
A heart attack has left a fixed defect in one area of the heart, but there is a reversible defect in another area of the heart due to a less severe blockage.
Good doctor-patient, patient-doctor communication and understanding is so very important, essential at ALL times.
Best of luck down the road of life.
WebMD member (since 8/99)
Coronary artery anatomy
Starting with the left anterior descending (LAD,) the most critical, next to the ultra-critical left main (LM)
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