Catherization after stress test and kidney disease

[jbernatdk]

I am a 72 year old male, overweight with diabetes and kidney disease among other problems.  I recently had a stress test with the following results:"Evidence for a mild ischemia in the basal anterolateral wall, probably within the distribution of the left circumflex.  No evidence in other vascular territory. Normal resting left ventricular systolic function with normal heart size, non transient ischemic dilation, calculated ejection fraction of 59%, with no wall motion abnormalities.  Also, normal electrocardiographic response to symptom-limited maximal treadmill exercise.

I also have no chest pain or other symptoms except minor shortness of breath.

My family doctor (through his nurse) recommends I go for a catherization.  I am reluctant to do this since I have stage 3 kidney disease and am concerned about the dye used.  Also, The results to me do not seem  startling for someone my age.

What would you do in my case?  Are the results serious requiring attention?

[Flycaster305]

Words like 'mild, normal' seem to be prominent in the procedure report.  

Given that you have severe kidney disease, like Ed, I'd discuss the cath with your Cardiologist.  I think your primary doctor is simply doing what he is supposed to do and referring you to an expert.  It seems you will balance risk vs. reward, and the risk factors seem to me from your post to outweigh the reward, but your Cardiologist can give you better advice.  Keep us informed.

[ed34]

Difficult choice and I can see why you want to see what others think. Although no one can really make the decision for you, what we may be able to do is offer different perspectives on this issue. If it were me, then I would probably go for the catheterization. Why? well here are the reasons which I concluded when I imagined this as my own body....

1. Ischemia is currently mild, but can turn to severe pretty quick.
2. When a blockage is intervened early on, it can be easier to treat.
3. Having treatment now is likely to prevent heart damage later on.

Those were the pros. However, there are some cons which I would be concerned about and ask the cardiologist. Which type of stent would he use. I certainly wouldn't want the stent causing lots of scar tissue and blocking the artery totally within weeks, making matters much worse. Does he consider the dye a high risk with the Kidney problems.

Personally, if it were me, and the Cardiologist can satisfy me about the cons, then I would have it done. You say you are 72 and keeping your heart healthy could add many more years to that.

May I ask what the cause is for your kidney disease? are you receiving dialysis?