Blockages & "mild anterior hypokinesis"

[AndyU]

I am a 43 year old male, in relatively good shape, non-smoker and non-drinker, who was recently diagnosed via catherization with two blockages in the left side of my heart. The report detailed "some mild luminal irregularities throughout is curse."  It also noted that the first diagonal branch ostium appeared to have a 40-50% stenosis.  The second blockage appears in the left circumflex coronary artery.  It stated that the left circumflex "at its ostium appeared to have a 30% stenosis."  Mild luminal irregularities were also noted.  Lastly, the Left Ventriculographic exam noted ejection fraction of 55%, which I  believe is good, but stated that "there appeared to be some mild anteroapical hypokinesis." And, that "there did not seem to be any significant gradient across the aortic valve via pullback fashion."  I have been treated for hypertension, but it is great now.  I have lost 65 pounds over the past 6 years and exercise fairly regularly.  6'3" and 200 lbs.  Cholesterol is normal range, triglycerides are low-normal.

1.  What does all this mean?  I understand the blockages, but how serious are the locations of the blockages?

2.  What are luminal irregularities? - Spots of hardened plaque or irregularities in artery anatomy?

3.  What would be a primary cause of the anteroapical hypokinesis?  With an ejection fraction still at 55%, could this indicate evidence of a mild heart attack at some point? Electrical problem? or just some anomaly that should not concern me.

I will, from time to time, note some rhythm irregularity and have experienced episodes of chest pain, both under load (exertion) and not.  Most times, I feel great and feel no effects during hard physical work, and yet I could be at my desk working and experience an episode of discomfort and/or irregularity for a few seconds.  What should I be doing?  I see a cardiologist on Sept. 28, 2009.  

Thanks for any input you can provide.

Andy

[itdood]

Well they didn't stent you right then and there during the cath, so that's positive.

You might be able to reverse some of the stenosis with lifestyle changes and statins.  It sounds like you already did some of that when you lost 65 pounds.  You say your cholesterol is in normal range, but to reduce plaques you have to get your ldl below 80 or 90 I think.

People with perfectly healthy hearts get rhythm disturbances.  I for one get lots and lots of PVCs, and it turns out I have no stenosis.