Confused

[mab316]

Hi just wanted to know what is a moderate intensity fixed myocardial perfusion defect in the apical anterior wall extending to the mid-portion which appears mildly hypokinetic. Clean coronaries on CT.

[mab316]

Sorry Dr. Anita, I had forgot to add that I had my ct scan done with an Iv and dye. Dose change any of the findings. It was noted that I had Pvcs while having the scan done. Thank you again.

[mab316]

Thank you so much for your response. The doctors have said my calcium score is a zero based on the ctscan and they believe I am having coronary arteries spasms. I just want to know what should I do next. I have bad chest pain, arrythmia and a resting heart rate in the 90's most days. I have never had this. My first stress test April of 2013, did not show any of these things. What would be my next best plan of action?

[Paderla Anitha, DNB]

Hi, in stress testing, perfusion defect that persists after exercise and at rest is referred to as a fixed defect. This means there is one or more totally blocked coronary arteries and one has had damage done to the heart muscle because of a heart attack. There is an area (or areas) of the heart muscle that has become scar tissue (scarring, scarred) because of the MI. This area would not be able to make functional use of any oxygen even if blood flow to that area of the heart were completely restored. After identifying the defects a cardiac catheterization helps to study the arterial structure of the heart and to identify the blocks for further therapy. A CT scan may not identify these blocks in the coronary arteries.  So, your doctor may next ask for cardiac catheterization. Please follow up with him. Regards.