What does all this mean and how soon can I feel better and possibility of return

[Miss: Gray]

I had a heart attack in june of 99 and a second cath three weeks later for heart muscle spasm i am still having spasm and my daily life activities are limited is it always going to be like this from now on ? going through my records I have found all this information but I do need it translated as my cardiologist has not really had the time to explain everything to me....
I had a non Q wave myocardial infarction with ejection fraction of 45%, ecg sinus rhythm and st segment changes ,ck 88 troponin4.3 H&H 14.6/43 myocardial necrosis left ventriculaogram shows anterolateral hypokinesis with discrete apical dyskinesis . Single vessel coronary disease with complex proximal lad stenosis proximal to first septal artey 90% stenosis with thrombus and narrowing after first septal artery in addition proximal right coronary has a 25% stenosis. Electro cardiagram in july had mild sinus rythm with mild t wave inversions in v1-v3.Unstable angina midclavicular line s1 is normal and s2 is physiologically split.further stress imigin is needed. thank you for youre time in helping me make sense of all this I dont understand...............

[Eugene P. Bartell]

My doctor has recommended that I have a Thallium Stress Test performed.  This was recommended because I have been experienced low grade aching in my shoulders and most importantly the EKG indicated left bundle blockage.  My cardiologist indicated I could have the stress test performed performed by use of a treadmill or with application of persantine.  What factors should I consider in deciding on which method is the best for stressing the heart?  Are there any particular advantages or disadvantages to either approach.  Two and a half years ago I had angioplasty which gave me relief from angina which I experienced only in my shoulders. A stent was inserted with the angioplasty at that time.  I have recently begun to feel that Iam experiencing mild angina in my shoulders again, but not as strong as two and a half years ago.  Also I have never had any pain whatsoever in my chest or neck or arms.  All of my discomfort has been an ache in  my shoulders, and only on several occassions would I considered the pain about a 7 on a 1 to 10 scale and that was more than two years ago.  I currently exercise on a bicycle and ride 2 miles in 26 to 28 minutes and have never felt the dull aching in my shoulders.

[CCF CARDIO MD - DLB]

I am surprised that your doctor is leaving the decsion to you as far as what type of stress test to perform - he should really be the one to determine this. Based on what you have written, I think a treadmill Thallium would be better than a persantine Thallium. The exercise portion of a stress test conveys a lot of information that a chemical stress test is not able to see.

[CCF CARDIO MD - DLB]

If the stent was used to treat the severe blockage that you describe and a repeat catheterization found no problem with the stent or any other new blockage, the symptoms may not be cardiac. Coronary spasm can occur, but long-acting nitroglycerin preparations and calcium channel blockers virtually always get rid of spasm.

[Ileana]

I had a heart attack in june of 99 andstent was put in at that time a second cath three weeks later for heart muscle spasm i am still having spasm that get extreamly bad at times and i have to take nitro and my daily life activities are limited is it always going to be like this from now on ? going through my records I have found all this information but I do need it translated as my cardiologist has not really had the time to explain everything to me....
I had a non Q wave myocardial infarction with ejection fraction of 45%, ecg sinus rhythm and st segment changes ,ck 88 troponin4.3 H&H 14.6/43 myocardial necrosis left ventriculaogram shows anterolateral hypokinesis with discrete apical dyskinesis . Single vessel coronary disease with complex proximal lad stenosis proximal to first septal artey 90% stenosis with thrombus and narrowing after first septal artery in addition proximal right coronary has a 25% stenosis. Electro cardiagram in july had mild sinus rythm with mild t wave inversions in v1-v3.Unstable angina midclavicular line s1 is normal and s2 is physiologically split.further stress imigin is needed. thank you for youre time in helping me make sense of all this I dont understand...............how can i go back to work if every day things cause spasm daily ?

[CCF CARDIO MD - DLB]

Asthma can cause chest pains, but usually only in association with coughing or shortness of breath. I would not expect nitro to have any effect on asthma. Perhaps you have an esophageal disorder - these sometimes respond to nitro.

[Ileana]

at the  second catherization is when I was told it was heart spasm and that further stress test should be considered if pain persist im currently on isosobide with no relif i do hoever have an appointment with my cardiolosgist this month and will mention it to him again also recently i have been diagnosed with asthma and im wondering if that has anything to do with why im incuring daily chest pains at times are very bad with relif somewhat after 2nd nitro but do not disapear completelly.but my main concer is working again because I just dont think I am able to at this time due to so much discomfort.

[CCF CARDIO MD - DLB]

The results indicate that you have had a heart attack. Part of the heart muscle is normal, part is weak and a part appears dead. Of the three major heart arteries, one has a very serious degree of narrowing, limiting the blood flow (likely the reason for the heart attack). It seems like your doctor is planning a stress test to decide if it is worthwhile to try and fix this blockage or whether it is too late to try anything (such as angioplasty or bypass surgery). Given your symptoms, assuming that they sound cardiac in origin, many cardiologists would opt to try and fix the blockage without any stress testing.