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Live with peri-infarct ischemia?

Live with peri-infarct ischemia?

One year ago I had an MI.  Emergency intervention resulted in 9 stents (2 places in circumflex and 2 (with lots of sandwiched stents) in RCA.  I continued to have angina (had it for years before heart attack, always diagnosed as acid reflux) and four months after MI had another stent to RCA for small (3 mm) 70% blockage.  Yet still continue to have angina with exercise and recent Nuclear Stress Test showed "mild peri-infarct ischemia".  So had an agiogram but no restenosis was seen.  I assume they also looked fo new or previously undetected blokages as well.

So I have not had a follow-up with my cardiologist, but when he came in while I was just coming out of procedure he said, para-phrasing, "Good news, no restenosis, go back to exercising and don't worry."

Yet to my mind two worrisome observations are still unanswered:  1)  I still have angina when heart rate gets to 90 and worse at 110 (goes away in 2 - 5 minutes if quit, or can rest a few and then continue treadmill with a lower acceptable level of discomfort).  2) The nuclear stress test showed ischemia, he said "perhaps peri-infarct ischemia".

Do I now just live with angina and ischemia, or should I still be diligently searching for cause and remedy for ischemia (I guess in the belief that my docs might be missing thee reason for the ischemia.)

Thanks for any thoughts, I realize you would need a lot more details (I'm willing to give) to be specific, but any obvious questions I should be asking my cardiologists or points that raise a general concern here?
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Since the cath showed no significant stenosis, the fact is that your epicardial vessels are sufficiently open to allow blood to pass through. It does not exclude microvascular ischemia which sometimes causes syndrome X.
You need optimal medical therapy with beta blockers, ace inhibitors, aspirin and plavix as well as long acting nitrates and perhaps ranexa. If these medicines don't control your symptoms and you are sufficiently limited EECP may be an option.
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