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Heart Disease  (Expert Forum)
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Ischemia and heart muscle damage
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Ischemia and heart muscle damage

by Pat, Oct 28, 1999 12:00AM
A very close friend of mine is a pilot.  During exercise in Feb. he experienced some shortness of breath.  It was time for his annual flight physical and the EKG showed some irregularities and he subsequently underwent angiography which indicated partial occlusion of at least one coronary artery.  I believe it was the LAD but I'm not quite sure on that.He returned for placement of two stents.  
     He just recently had Thallium stress test done.  Apparently the cardiologist recommends "no further treatment", but his regular flight physician told him that the test did reveal ischemia, and the cardiologist earlier had told him a small area of his heart had been damaged.  Neither doctor mentioned Myocardial Infarction.  
     He continues to have shortness of breath with moderate exercise.  He says he has never experienced any pain. Of course, his license has been suspended and it does not appear he will be able to get it back mainly because the term "ischemia" was used in the test report.  Also, he just told me that at the time of the flight physical, they had found his triglyceride levels elevated into the 500's and put him on Lipitor.
     My question is:  1)Is it possible to have this ischemia and heart damage, and NOT to have had an MI? 2)What are the chances of him having an MI in the future? 3)If he has NOT had an MI, what are the indications for his future health with this history and the untreated ischemia?  I am very worried about him.
                Thanks, Pat M.

by CCF CARDIO MD - DLB, Oct 28, 1999 12:00AM
PostReply&forum=cardio&message=31140&topic=Ischemia&subject=Ischemia and heart muscle damage&replyto=Pat&replytofile=31140.html&name=CCF CARDIO MD - DLB
Member Comments (2)

by CCF CARDIO MD - DLB, Oct 28, 1999 12:00AM
My previous answer appears scrambled by the computer.

If there is heart damage, that usually means MI. Ischemia does not mean an MI, just a risk of future MI. I am concerned that he has symptoms of shortness of breath with exercise and ischemia on a thallium, with a history of two stents. Generally, I would recommend a repeat catheteriztion for that sort of patient and, from the information you provided, it is not clear to my why this is not being done.
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