Infarct in the distal to basal inferior and inferolateral wall
This is my Mpi report: Stress and rest tomographic imaging with Tc-99m tetrofosmin revealed a large moderate to severe minimally reversible defect in the distal to basal inferior and inferolateral walls of the left ventricle. The mid to basal inferior and inferolateral walls did not appear viable. The amount of ischemia was minimal and mainly in the distal inferolateral wall (<5%). The stress defect represented 27% of the left ventricle by polar map quantitation. Post-stress GatedSPECT showed normal LV size and impaired LV function with akinesia of the inferior and inferolateral walls (post stress LVEF 48%,EDV 101 Mel's,Rest LVEF 54%, EDV 102mls. Conclusion: Scan evidence of a large infarct in the distal to basal inferior and inferolateral walls of the left ventricle with minimal ischemia in the distal inferolateral wall at Stage 3 Bruce Protocol
Agiogram result: Right dominant. Left Main:40% stenosis. mLAD 40-60 calcified. LCX normal. pRCA 95%stenosis. m-d RCA 90%stenosis.
Transthoracic echocardiography result
Normal LV size and systolic function. LVEF 50%
SWMA seen at rest suggestive of underlying I H D
Normal LV filling pattern
Normal RV size and systolic function
Normal LA and RA cavity size
All valves are morphologically normal. Mild MR and Trivial TR seen
Intact IAS and IVS
No intracardiac clot seen
Is my condition serious? These are results of silent MI. Doctor said no point opening up RCA as the tissue it serves is already dead. Should the LM (40% blocked) and LAD 40-60% be opened up? Currently only on medication. What is my outlook? To stent or not to sent?
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