post stent stress test

[Jay4471]

hello  got a stent 2months ago for 100% mid-lad blockage. nuclear stress test prior to intervention noted 'large inferior apical wall perfusion defect most consistent w/ diaphragmatic attenuation artifact'.  exercise was good, ef was 56% and my symptoms overall were mild. Had new stress test w/ different office that placed stent and the result was 'probably' normal Lv perfusion showing 'small, fixed defect in the mid inferoseptal, apical inferior segment consistent w/ attenuation artifact. exercise was good as was ef.  ? is should there be no defect or is this normal to have it go from large to small? its been only 2 months so could this be an indication of an early re-stenosis or is it too soon and the 'small' defect will get better over time? thanks for any input.

[Jay4471]

      thanks for reply.   Think the real question am asking is first test showed large defect consistent w/ artifact that turned out to be 100% occluded artery and new test showed small defect consistent w/ artifact in same area so assuming this is not artifact is it normal to have small defect remaining after stent placement or should there be no defect at all considering there was no heart attack?
                              

[CCFHeartMD19]

Hello Jay4471

it is hard to give you an accurate answer over the Internet without reviewing your history and examining you personally. However, I will try to give you some pointers that are helpful.
One of the most important things that cardiologists use to base their decisions to do cardiac catheterization are patient symptoms.  I presume that the stress test that  was done on you 2 months ago was due to occurrence of symptoms.
Routine stress testing after performance of cardiac catheterization and/or  stenting  is not indicated if the patient is not really experiencing any symptoms. One  of the major limitations of stress testing includes false-positive result, wherein  the stress test is read as positive when there is actually no problem.  I suspect that in your case if you not having any symptoms, the  stress this is likely false positive. It is  also reassuring that you do not have any “reversible ischemia” on your stress test.
Of course,  if you are having symptoms or develop symptoms  of chest pain or shortness of breath in the future, a cardiac catheterization may need to be repeated.

Hope that helps
CCFHeartMD19