Heart Disease and Abnormal LexiScan

[Larryheadhunter]

I had a recent Lexiscan due to shortness of breath and no angina with results abnormal.  I already have 12 coronary stents, the latest in Sep 2013. The scan revealed a small fixed apical defect, reversibility is noted, involving the inferoapical wall extending into the inferior lateral wall. The impression stated it was a small infarct, ischemia seen involving the inferoapical wall extending into the inferior lateral wall.
My echo cardiogram was normal, my ejection fraction was 61%.
What does all these words mean? I have never had chest pain, but I do have PTSD and anticipatory anxiety from Vietnam at age 18,  which mimic a heart attack. I have low blood pressure and all the docs say I am atypical heart patient.  One cardiologist said it was a small heart attack, and another said it wasn't. My wife is freaking out.  What is it and what should I do?

[CCFCardio MD2]

First of all, given you have no symptoms and your heart pumping function (ejection fraction) is normal, you don't have much to worry about.  A fixed defect on a stress test often means there was a heart attack in that area in the past, though not always.  It could just be artifact, especially in the territory you describe, so it may be nothing.  Reversibility does suggest ischemia, or poor blood flow to an area of the heart which is still alive.  My best advice is to sit down with your cardiologist and review the study.  Hope this helps!

[Larryheadhunter]

Thank you Doctor, good advice. Since posting, my new preventative Cardiologist, said that it could have been a misread pre existing stent, and he said I should get the blood test reports from the hospital and Cardiologist that did the Lexi Scan Dec 3, to see if my enzymes had changed for the worse during that period of time, and to him the would be the golden plate, that if my enzymes were stable I most likely didn't have a heart attack.If they were up I did have a mild heart attack.
There is also confusion, as my ER Visit Dec 3-4, to Mission Hosp, was strange as my Cardiologist ordered the abnormal LexiScan but never came to see me. The Hospitalist Doc strong armed me into skipping the angiogram at that time, telling me he reviewed my records and felt that my creatinine was too high and recommended a change to a healthier life style. Said the dye was too toxic, and might throw me into kidney damage and possibly dialysis. He spoke to the Cardiologist, who unfortunately didn't see me and give me his recommendation. That is why I have a new Preventative Cardiologist who put me on metropolol immediately and sent me to the hospital for an angiogram Dec 24. The Interventional Cardiologist told me just before the last angiogram that she thought I had a mild heart attack, which really scared me as no one else had actually told me that. The angiogram came back all 12 stents were totally patent, and said I was good to go.I don't know who to believe, other than trying to get my hospital blood tests for raised enzymes and see once and for all what's going on with me.What's perplexing to me is the ridiculous of these docs who refused to make a diagnosis, or made one based on 1 sentence on the Lexi Scan report from the radiologist. I may never know whether I had a heart attack or not. I am eating no processed foods, mostly organic, only meat I am eating is small portions of organic chicken, veggies and fruits. I am trying to follow a modified version of Dr. Caldwell Esselystein's diet, How to maintain and preserve your heart, which is the same one that Bill Clinton follows.