My 63 year old husband had a chemical stress test today and the results indicated a "moderate scar in the left ventrical inferior wall, no stress induced ischemia,and ejection rate is 63%. He has no known history of a heart attack, but does have HBP,controlled.
My question is could this scar be from a cardiac cath he had 35 years ago (turned out to be a seperated sternum) or does it definately mean he has had a heart attack.
Scar tissue would indicate necrosis of heart cells and this ooccurs when heart tissues do not receive an adequate supply of oxygenated blood...usually due ischemia (vessel blockage). Your husband could have had a silent heart attack years ago and not aware. It is possible to have had a clot that impeded blood flow enough to cause damage, and then the clot dissolved. Or there could have been spasm of the coronary artery long enough to block blood flow and cause cell necrosis.
I don't believe a cath could cause heart cell necrosis
Sometimes people do get injured by the cath, so I would wonder the same thing as Koop123. But like kenkeith, I have a hard time imagining a cath injury to the ventricle wall that would be bad enough to cause a permanent scar. Don't take me for any kind of expert, but the cath injuries that I have heard about were more along the lines of the cath puncturing a thin vessel wall. If you think about the amount of force it would take for the cath tip to leave a scar on your skin, that's a lot of force. I imagine it would take a similar amount of force for it to leave a scar on your ventricle wall. Why would the doctor push that hard and keep on pushing? People do sometimes have heart attacks that they don't know about at the time. Maybe you are going to have to live with never knowing for sure about this. I'm a person who likes to know, so I can identify, but unfortunately, you don't get answers to everything -- especially things that happened 35 years ago and especially things that are hidden away from sight. I hope your husband is doing well now.
Yes I doubt that injury from a catheter would be enough to produce a large enough area of scar tissue to even be detected. It would literally be like a pin *****.The main thing to
look out for with scar tissue is the formation of an aneurysm. If the wall becomes too weak, it will bulge out and the efficiency of the chamber may be impaired. Corrective surgery can be performed though. From the look of the EF of 63%, this doesn't seem to be a problem but it depends how long the damage has been there and the size.
I would ask your cardiologist about this, he should be able to give you the facts having an idea of the area of the scar tissue.
Having an EFof 63% would almost eliminate the possibility of a ventricular anuerysm, and almost always there are symptoms. It generally occurs within the first couple of weeks after a LARGE heart attack and is a rare consequence.
"Heart Aneurysms, although rare, typically occur within the first two weeks after a large heart attack. Following a large heart attack much of the heart muscle in the left ventricle (main pumping chamber of the heart) may be dead. Dead muscle and scar tissue may stretch and dilate to form an aneurysm. Symptoms may include chest pain or pressure, pain in the jaw or arms, trouble breathing or fainting spells. Rupture of a ventricular aneurysm is usually fatal."
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