The perfusion is the blood supply to the heart tissues.
Your report suggests that there is a fixed perfusion at the tip of your heart. Fixed means it was the same during stress and rest. This would indicate that there is a area of scar tissue, most likely due to a past heart attack.
This is confirmed by the remark that there are signs for MI (myocardial infarction) involving the tip and heart wall near the tip of the heart.
Still, the amount of blood that you heart pumps is good with 56%. The normal range for EF (ejection fraction) is 55-70%.
The damage that the MI did to your heart can not be repaired.
Medication depends on the cause of the MI, but will probably include a beta blocker and aspirin.
my final diagnoses was chest pain concerning for acute coronary syndrome