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Understanding cardiac report
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Understanding cardiac report

The following is on my Dad's report but the doctor has not explained this very well.  Could you please explain what is going on and how serious this is?

The patient underwent a Lixiscan Cardiolite revealing medium, moderate to severe, anterior apical, fixed defect, as well as a small, mild to moderate inferior, partially reversible defect.  Ejection fraction was estimated at 55%.  Patient denies chest pain, palpitations, presyncope, orthopnea, or significant lower extremity edema.
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There is a medium sized, moderate to severe defect in anterior and apical wall that is fixed suggestive of infarct.  The is a small mild to moderate defect in inferior wall that is partially reversible suggestive of infarction with minimal peri-infarct ischemia.

Lungs reveal diminished breath sounds bilaterally, but no frank wheezes or rales.  Heart: Without murmur, normal S1 and S2.  There is no S3, S4 or rub.Apical impulse is normal.
***
We think maybe he has had a silent heart attack at some point.  Is his heart function compromised? (moderately, severely? etc)  Any help would be appreciated.  Thank you
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159619_tn?1318997813
Your father has experience an MI at some point which is indicated by the comment "There is a medium sized, moderate to severe defect in anterior and apical wall that is fixed suggestive of infarct". He also has another area with a partially reversible defect which may be treated with meds or a stent depending on the severity. The good news is that his heart is still functioning well with a normal EF% of 55% which represents the amount of blood pumped out of the left ventricle with each beat.

Have his doctors recommended any treatment options yet? He sounds like a candidate for an angiogram to see exactly what kind of shape his arteries are in.

Let us know,

Jon
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367994_tn?1304957193
Almost always a stress test is given when the individual has symptoms and that usually is chest pain.  The chest pain is the result of insufficient blood supply to heart cells and that would indicate oxygenated blood is not adequately supllied to the heart cells.  Your father appears not to have any chest pain and that can be the result  "silent ischemia"....meaning there are no symptoms, but there is a lack of sufficient blood flow!!
But that can be ruled out because your father's heart is pumping effectiovely.  

It appears your father may have had a silent heart attack, and that would explain the infarct (necrotic heart cell, dead)...if true.  But a good EF indicates the heart has sufficient contractility to pump adequately.  I had exactly the same situation 7 years ago and I had had a slilent heart attack, and my first symptom was heart failure (EF below 29%), enlarged left ventricle, pulmonary edema as the heart wasn't strong enough to pump the amount of blood received into circulation and the blood backed up into the lungs causing hyperventilating, dry cough, shortness of breath and fast heart rate.

If your father has had some heart cell damage as the report seems to indicate, your father should have an echocardiogram.  The echo will show if there is any heart wall movement impairment (some loss of contractility).  My echo showed hypokinesis (heart wall movement impairment),  Also, the echo will measure the heart's wall and chamber sizes...if the heart is enlarged from a silent heart attack  that could indicate a more advanced condition.  The echo will answer your questions: had a silent heart attack?  Heart function compromised and if so to what extent?

Hope this answers your questions and if you have any furthere questions or comments you are welcome to respond.  Thanks for sharing, take care.

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