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Your dad's test shows some areas of the heart are not getting normal blood supply. In addition, the hypokenesis means parts of the heart are not contracting quite as they should be, which corresponds to the EF of 47%. EF is ejection fraction, the amount of blood ejected from the heart with each beat, and normal is 50-70%. It appears your dad probably has ischemic heart disease, based on what this report says. Fixed defects are considered a high risk for future cardiac events such as heart attack, so they rquire aggressive treatment to modify risks. This may include one or more of the following: medications, stents, bypass surgery and so on, depending on the person, the severity of the defect and the patient's overall condition.