IHD

My aniographic report is  as under
Catheter Procedure:-

Through right femoral artery Salinger needle Pigtail no 6F passed to aorta and LV after injecting heparin. LV aortic pressure recorded.

Aortic Pressure    165/75 mean 110 mm Hg
LV        130/5 mm Hg
EDP        12 mm Hg

Left & Right Coronary Angio done with Judkins Coronary Catherter no 6F

Angiocardiogram  Report:-

LCA LMS: Normal

LAD: Long area of critical disease proximal course.

LCx: Dominant. Maj OM has moderate disease.

RCA: Non dominant with moderate disease.

LV Angio:      Ant wall hypokinesia with overall mild LV dysfunction. EF 45%.

My Myocardial perfusion report is as under:-
Clinical History:- A 43 year old man a known case of IHD, who had an anterior MI (SK+) in 2003 and an inferior MI in March 2007 and is presently asymptomatic. He is positive ETT with anterior hypokinesia on 2-D-echo. Coronary angiogram show multi vessel disease with a long critical segment in proximal LAD.

FINDINGS:-
Myocardial perfusion stress images show areas of much decreased to minimal radiotracer uptake in the apex, adjoining septum and apical to mid anteroseptal wall, with minimal to absent tracer uptake in almost all of the posterolateral LV wall. Rest images show minimal change in the mid to basal posterolateral and part of the mid anteroseptal wall, with tracer redistribution noted in other areas.

IMPERSSION: 1. Mid anteroseptal fixed defect, with     peridefect ischaemia (LAD distribution.

2. Moderate sized posterolateral fixed defect, with peridefect ischaemia (confluence of RCA and LCx territories)




Q-1 Please explain above report specially impression 1 and 2 in detail and advise accordingly.

Q-2 How much area of my heart has been damaged. (pleae tell me percentage of damage)
Q-3 Do I need stenting if yes then which stents DES or BMS? Can I implant BMS stents because I am a poor Pakistani and could not afford DES due to high cost
Q-4 Does this situation lead to CABG?
Q-5 Does I have blockage if yes then what is its percentage?
Q-6 What is most suitable option for me?
With regards
I will be more thank full to you

Shabbir Ali Naqvi

[Shabbir Naqvi]

I have send  my reports on 29 september but i am still waiting for reply. Please...............reply soon with best regards. Thanking you in anticipation.
Shabbir Lahore Pakistan