Stress test results

[ccstar66]

I am a 40yr old female.   I had 6 stents put in and a ICD in Dec 08 due to a low EF of 20% and AF.  I have been having chest pains and shortness of breath and the feeling that I am full.  I am on many meds.  I had another stress test and I am just not real sure of what the results all mean.  Tried talking to my doctor, but he didn't explain it real well.  he just said he wants to do another catherization.  I was wondering if you can explain my results for the nuclear Spect Imaging Study?

Findings:
1.  Left ventricle appears at least borderline enlarged. Moderate sized perfusion defect is seen that involves the inferior wall, partially reversible and may represent a region of scare with peri-nfarct ischemia.
2. Area of decreased perfusion involving the anterior and anteroapical walls.  Stable on both stress and rest.  It may represent an area of myocardial scar.  A degree of breast attenuation is not excluded.
3. Left ventricular function appears moderately impaired at 35% with generlized hypokinesis.

Conclusions:
1. Abnormal myocardial perfusion study.  Suggestion of an inferior wall defect, partially reversible suggesting myocardial scar with peri-infarct ischemia.  Second defect involving the anterior wall is fixed and may represent regions of scar and degree of breast attenuation is not included.

I would appreciate your thoughts...Thanks

[Cleveland Clinic]

You had a heart attack in the past that involves the front (anterior territory) of the heart and that territory is dead (scar) and unlikely to cause your symptoms.  Scars can't be revascularized because they are already mostly dead.  There is also a scar  (dead area) in the back of your heart (inferior territory) with low blood flow to its periphery (surroundings) which may explain some of your symptoms and you may therefore benefit from revascularization, ie, catheterization.  I would recommend a catheterization in this situation as well.  You should also be on optimal medical therapy that includes a beta blocker and an ace inhibitor as well as a statin.  Sometimes, nitrates may help with these symptoms, but revascularization will likely be more successful.  

[ccstar66]

I reRcently had another angioplasty done and all the main artieries are clear, but i am still having chest pains on my left side the middle and now they have gone into the right side of my chest as well right behind my right breast.  The doctor put me on another med, Renexa to help with the angina, but it doesn't seem to be working either.  I am on many other meds as well, Coreg, Risperdal, Ticlid, Cilistozal, Lipitor, Nitro spray and diabetes meds.  My last EF number was 40% up from 30% month ago, but the pain is worse now waking and keeping me up at night and I am also having palpatations and some shortness of breath and very tired all the time.  I want to know what else could be going on or what I can have done or is there nothing else?  I asked the doctor if there was anything to be done for the dead areas in my heart and he said nothing can be done.  

If nothing can be done, what chances do I have to live another 5 years?  

[ccstar66]

Would I benefit from any type of surgery such as a bypass?  They wanted to do one back in August, 2008, but the surgeon said due to my overweight and diabetes he was affraid I would have to many complications.  This is a small hospital in Florida and I really didn't get a second opionion at the time, but am thinking I should at a bigger hospital like Tampa General or even Shands in Gainsville, Florida.