Regarding Eccentric calicific in the RCA and distal LAD

[laxmikant]

Dear my father is 73 years old. He had Aortic valve replacement in 1997.Recently he felt heaviness in his chest during his evening and morning walk. Cardiologist suggested to get Stress thallimum test.The result was as under: 1.Stress induced reversible perfusion defect of mild to moderate severity in the part of apex and apical anterior segments and the basal inferior and adjoining basal inferolateral segments involving 12-14% of LV myocardium.
2.Adequate perfusion is seen in rest of the apex, anterior wall, inferior wall, lateral wall and septum of the LV myocardium.

On the basis of this cardiologist advised to get CT coronary angiography. The result of the CT coronary angiography as given below:
1.Eccentric calcific in the RCA and distal LAD causing mild (20-30%) luminal narrowing.
2. No evidence of hypo perfusion or perfusion defects in the resting first pass myocardial enhancement.

Now our cardiologists has advised to get catheter angiography to rule out further.

Please advise me what should me my course of action.

Regards

[ed34]

I would agree with the Cardiologist. Something is affecting the left side of the Heart, and this isn't a 20-30% blockage, it has to be something more severe.

[Paderla Anitha, DNB]

Hi, as you can see there have been controversial results from both the tests done. The stress thallium test has shown reversible defects. Reversible perfusion defect is an area of the heart muscle that does not receive an adequate amount of blood at stress (ischemia) but does so at rest (reversible ischemia).

But CT coronary angiography does not reveal any defects. So, the next course of action is cardiac catheterization, this helps to study the arterial structure of the heart and to identify the blocks for further therapy. So, your doctor has asked for cardiac catheterization. Please follow up with him. Regards.