NM Myocardial Perfusion Scan question

[ontrose69]

I just had this done and my doctor posted the results for me. I haven't had a follow up appointment yet, but I would like to know in lay terms what the results mean for me. This way I can have some questions for my doctor when I follow up.
Scan Interpretation:
The left ventricular cavity is normal measuring 100mL on the stress studies.  There is no evidence of abnormal lung activity.  Additionally, the right ventricle is normal.

SPECT images demonstrates a predominantly fixed inferolateral perfusion defect with mild reversibility suggestive of infarction with mild peri infarct ischemia.

Gated SPECT imaging reveals hypokinesis of the inferolateral wall.
The left ventricular ejection fraction was low normal and calculated to be 51%.

FINAL IMPRESSION:

1.  Myocardial perfusion imaging is abnormal.  A predominantly fixed inferolateral perfusion defect with mild reversibility suggestive of infarction with mild peri infarct ischemia.
2.  Overall left ventricular systolic function was low normal with regional wall motion abnormalities

Some background history on me:
I had an MI in 2010 from vasospasms. I cannot remember exactly how much damage was caused by it. At that time, my arteries only had about 15% blockage. I have had vasospasms for over 25 years. Six months ago, I had severe chest pain and ended up having two stents put in. Now, I am having the same type of pain, hence the new MIBI scan.

I know that I had some minor damage to my heart from the MI, but I am not sure what these results mean for me. Am I looking at possibly needing more stents?

Thanks in advance for any insight into this!

[ed34]

You know it does amaze me when I read "I know my body well enough". I'm not being rude, but we do make mistakes. Over a year ago I got myself to hospital pretty damn quick because I felt like I was having my third heart attack. It turned out after tests that I had acid reflux. I was so sure it was a heart attack that it scared the hell out of me. After 2 weeks of omeprazole, everything returned to normal. From what you say about a lot of fluid around the heart, you do know this can cause a lot of pain? The heart is in a sac, surrounded by a small amount of fluid for protection. If this pressure builds up, the heart has to work harder to pump the blood and you will get pains. What concerns me is what caused the fluid build up? is it due to your kidneys being at 80%?

[ontrose69]

Two weeks ago I had a heart cath done. The doctor said that I have two arteries with about 60 percent blockage, but the blood flow is adequate for now. I also have a lot of fluid around my heart and he gave me a prescription for lasix. The problem that is I have chronic kidney stones and mykkidneys are at 80 percent of normal. He decided not to do anything about the partially blocked arteries at this time. He did say that my chest pain was not caused by my heart. I have to say that I am not in agreement with him on this. I am probably going to get a second opinion. I have to say that I think I know my body well enough to know when the pain is from my heart or if it's from spasms or something else. My urologist trusts me when I tell him I have anotherstone.  

[Flycaster305]

By no means take my comments any more than two heart patients discussing a test.  I've had a lot of stress tests, and here is what I think... I don't see anything mentioned about plugged arteries or the need for new stents.  The final impression suggests you have a dead area of your heart, obviously not too large or your EF would be worse than low normal.  The fact it is 'fixed' indicates that there aren't many stunned cells that can be rejuvenated with drugs, etc.  
There is someone on this board that is a medical professional with a lot of experience with vasospasms, I'll alert her to your post.