Is a CABG recommended for this impression???

[Nate55]

EF = 38% {R2}
EDV = 163 ml
ESV = 101 ml
SV = 62 ml
Mass = 184 gm

These are the values registered through a Myocardial perfusion study using nuclear medicine (Adenosine). The doctor has recommended for a by-pass grafting surgery. I request your best advice and recommendation for this case.

The patient is aged 52 yrs and is in course of Aspirin, Famotidine U.S.P, Isosorbide Dinitrite I.P, Clopidogrel U.S.P, Enalapril Maleate Tablets IP, Atenalol Tablets I.P, Tonact 40 and Alprax; from 2 months.

Are these pills helpful in any way to unblock arteries? Is CABG manadatory as per the values indicated above? Your advice is of extreme high value and appreciation. Please HELP.

[kenkeith]

What you have shown are volume metrics that support a low EF.  Ejection fraction (EF) is the amount of blood pumped into circulation with each heartbeat. Normal EF is 50 to 70%, and a low EF indicates there is reduced contractility of the left ventricle.  It appears from you information there is an ischemic (lack of blood flow) condition caused by vessel blockage.

There are 3 therapies for ischemia.  Medication can dilate the vessel blockage, and the flow of blood is increased and as a result there are no symptoms with the medication.

If medication does not provide relief of symptoms, then a stent implant would be the appropriate.  Sometimes stents can't be implanted due size, location, etc. then a bypass (CABG) would be the appropriate treatment.

I had a heart issue 6 years ago and a totally blocked LAD and a circumflex 72% blocked, and  I  am doing well with medication... my heart returned to normal size and EF is normal as well

I see you are taking Isosorbide for chest pain.  Does that relieve you chest pain (angina).  I have been taking that med for years and before going to the gym for workout I take that med and no problem with angina..