stress test

[delboy1951717]

hi i went for stress echocardiogram after i had a heart attack on the report it states at rest the mid apical septum and apical inferior segment are akinetic and the mid anteroseptum apical lateral and apical anterior segments hypokinetic ther was no response to dobutamine in these segments indicating irreversible ischaemia in the akinetic segments please what does this mean many thanks

[delboy1951717]

  
  hi many thanks for your help in the matter of my stress test and my heart
   attack it as been very helpfull many thanks

[ed34]

I think that is one stent, 23mm in blockage terms is long. That's virtually an inch in length.

[delboy1951717]

hi
     yes my heart attack was in my left artery it was stented they also found
     i had residual thrombotic lesion in my right coronary artery which was stented 3 days later they also found the circumflex artery was a non
   dominant artery with severe long segments of disease at my stress
   test they found the posterior wall becomes hypokinetic at peak stress
  they also say i have mild L.V impairment not sure what this means
   the first time they stented me they used 3 x 23mm drug eluting stent is that 3stents or just one can you throw any light on this for me
                               many thanks

[ed34]

I believe it's referring to the wall which separates the two large chambers of your heart (the ventricles). The top section is not noticeably moving, and the middle section is moving but well below normal. They are saying that after dobutamine was administered, a beta stimulant, there was no increase in activity in the top part of the septum. I'm confused because it states irreversible ischemia? This means that the muscle in that area is dead. The reason I am confused is that if a 99% blockage was responsible, then how would dobutamine be expected to improve matters? It wouldn't supply more oxygen to the heart muscle as it started to increase in rate. So I wouldn't expect to see any change. If anything, I would expect heart muscle to remain the same or be worse in function.
Maybe others will comment, but personally I would think a nuclear perfusion scan is the only accurate way to determine which areas have died, if any?  I assume your heart attack was due to a blockage in the Left Anterior Descending artery? was it stented? Are there any other blockages which were left untreated?