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    Shortness of Breath, some occasional sharp "rib" pain,
    StaciParker77 posted:
    My husband is 42, 5'11, 180, non smoker, Has had shortness of breath, and some occasional sharp pain in his chest.
    He went for a stress test, echo, ekg
    The results were:
    Ejection fraction 45%
    moderate fixed ischemic defect in basal inferolateral and mid inferolateral location LCX artery
    LV Mildly dilated systolic dysfunction
    they told him part of his heart was 'DEAD'. At the same time said he appear healthy, heart rate good, and to continue on with normal activities. I am so confused!!! What does all of this mean?
    cardiostarusa1 responded:

    "LV Mildly dilated systolic dysfunction"

    The left ventricle (LV, pumps blood out to the body except the lungs, which is handled by the right ventricle, RV) is mildly enlarged with systolic (heart's pumping phase) heart failure.

    How the Heart Pumps

    Animated Tutorial

    "Ejection fraction 45%"

    Understanding Your Ejection Fraction

    "Moderate fixed ischemic defect in basal inferolateral and mid inferolateral location LCX artery"

    The Basics

    The two main concerns regarding a nuclear stress test involves an actual narrowing or scarring, that is, the findings of reversible (ischemia) or non-reversible (fixed, permanent, scar tissue) perfusion (blood flow) defects.

    After stress myocardial perfusion imaging (stress MPI), 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, e.g., ANTERIOR/ANTERO (front wall), POSTERIOR/POSTERO (back wall), INFERIOR/INFERO (lower area/lower wall area), 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.

    "They told him part of his heart was DEAD'"

    If/when an actual heart attack (myocardial infarction, MI) has occured, the area affected (infarcted) will be deemed "dead" or medically-termed akinesis.

    Best of luck to your husband and you down the road of life.

    Take care,


    WebMD member (since 8/99)



    Be well-informed


    Isotope - Nuclear Stress Test

    SEE actual rest/stress images.

    Coronary artery anatomy

    Starting with the LAD, the most critical, next to the ultra-critical LM



    Heart Disease TYPES

    Men and Women

    Acquired or congenital (born with it)


    Mayo Clinic

    Heart Disease

    Definition. Symptoms. Causes. Risk factors. Complications. Tests and diagnosis. Prevention......

    Heart disease is a broad term used to describe a range of diseases that affect your heart, and in some cases, your blood vessels...


    LEARN ABOUT the Heart


    The Heart: (Human Anatomy) Pictures, Definition, Location in the Body and Heart Problems


    WebMD/WebMD forums DOES NOT provide medical, diagnosis or treatment.
    James Beckerman, MD, FACC responded:
    I agree this seems like a mixed message.

    His stress test is suggestive of

    1) Mildly reduced heart function (Ejection fraction 45%)
    2) A prior heart attack (fixed defect)

    It would be worth discussing further with his doctor, as this may influence appropriate medications to reduce future risk as well as consideration of further diagnostic testing, such as a coronary angiogram, to further define his coronary artery anatomy and any possible recommendation for treatment.

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