Can you please clarify?

[lisaloo820]

Can you please clarify for me what "imaging may be obscured with attenuation artifacts" and "other findings may be mid todistal inferoapical ischemia" mean?  Also what is catherization?  Is that when they put in a stint?  I am a complete wreck over all this and I am definitely seeking several opinions.  

[RCA7591]

Sure.

Often times (and particularly in women), certain artifacts may be present which distort the quality of the stress and rest images. Among the most common terms would include:

(A) Mild Diaphragmatic Attenuation Artifact
(B) Diaphragmatic Attenuation Artifact
(C) Chest Attenuation Artifact

Any one of the three may grossly distort the imaging of the heart in a way that suggests ischemia (reduced blood flow) or blockage (narrowing of a coronary artery). Both the chest and diaphragm (in some individuals) impede certain views of the heart. These artifacts, when present, may lead to "false positive" findings.

When this occurs, it is difficult for the Cardiologist to make a determination as to whether there is a genuine blockage or not. Therefore, abnormal findings are usually followed-up with Cardiac Catheterization.

Cardiac Catheterization is usually performed in the left side of the heart, and consists of catheterization, coronary angiography, and left ventriclography. Hemodynamic data is obtained, the ejection fraction is measured, and angiography is performed using contrast dye to determine if any blockage is present. The actual procedure itself takes about 15 minutes.

If a blockage is found, the Cardiologist may then use angioplasty or a stent to open the affected artery. This is usually performed at the same time as the catheterization.

Normal results would be:

- LEFT MAIN TRUNK: normal
- LEFT ANTERIOR DESCENDING: normal
- LEFT CIRCUMFLEX: non-dominant, normal
- RIGHT CORONARY ARTERY: dominant, normal
- LEFT VENTRICULOGRAPHY: > 55%

A second opinion is always a good idea (sometimes, a third).

-Ryan