stress test results

[bucklandk]

Husbands diagnoses: atheroscler native cor art / hypertension / hyperlipidemia ot / diabetes mellitus / cva / periph vascular dis / carotid art occlus w infarct / depressive disorder.

Stress test result: test with myocardial perfusion imaging revealed mild to moderate ischemia involving the basal anterior septum and mid anterior septal walls.  He is status post recent (4/7/08) four-vessel bypass graft with a LIMA to the LAD.

My husband has been labeled a walking piece of plaque by his cardiologist.

With his open-heart surgery being so recent, with him being diabetic, and he has never had any symptoms of his illness - should this recent test be looked into further by your opinion?  His cardiologist feels since he has no symptoms, we should wait for further test in approx. 1 year.  I'm very conflicted and we have only just started with this new doctor, so I'm unsure whether to trust him or my gut.

[kenkeith]

One can have occluded heart vessels and not have any pain (angina)!.  I didn't know I had blocked arteries until having congested heart failure.  Also, unblocked vessels (less than 50%) is the usual cause for fatal heart attacks.  It results because the usual tests only view the lumen (inner channel) but it does not show the soft and hard plaque between the inner wall and the outer smooth muscle.  Most heart attacks happen when this soft plaque rutures the inner lining and develops clots.

It is not a very good answer to your question, but there can be occlusions without angina, and an occluded vessels is not usually the agent to cause a stroke, heart attack.  The walking piece of plaque indicates your husband has elevated plaque between the inner and outer wall.  I recently had a CT angiogram that determines by a calcium score the degree of calcification and soft plaque and the quantification indicates the degree of risk for a heart attack.