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Perfusion defect involves basal segment of infero-lateral wall - what does it mean?

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don47
don47

FINDINGS: 1) Left ventricle cavity is normal in size. 2) Stress images show perfusion defect involving the basal segment of the infero-lateral wall. 3) Rest of the left ventricle myocardium shows homogeneous perfusion.  4) Rest images show complete reversibility of the perfusion defect seen in the stress images. 5) Gated SPECT images show normal wall motion with good function. 6) EF score: 77%

OPINION: 7) Scan is positive for inducible ischemia of basal segment of infero-lateral wall. 8) Normal sized ventricle cavity with good ejection fraction. 

Could someone please help me understand:

a. perfusion defect means: inadequate supply of blood to the heart tissue? 

b. EF means 'ejection fraction'?  is 77% normal or abnormal?

c. How severe is this, could it be reversed?

d. What are normally next steps?

 

0 likes, 2 replies

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  • don47
    don47

    Posted

    e. Currently I take blood pressure and diabetes meds, and one aspirin a day. Are there any powerful supplements or medications that I can take to help manage this condition?
  • don47
    don47

    Posted

    I'm still going through testing, though after googling, to question

    e) seems like: Surgery is counterproductive (unless there is tissue death and EE is < 50%) and medical therapy is recommended first.  A typical plan includes (ACE inhibitor, beta blocker, long-acting nitrate, Calcium channel blocker)

    i. Aspirin (Benefit: prevents blood clots from forming.  Negatives: stomach ulcers, during stroke bleeding into brain risk)

    ii. beta-blockers (Benefit: prevents adrenaline and norepinephrine i.e. fight-or-flight i.e. anxiety and stress responses in smooth muscles; lowers blood pressure.  Negatives: edema (fluid retention), fatigue/slows you down, weight gain.

    iii. ACE Inhibitors - relaxes blood vessels and lowers volume of blood leading to low BP and decreased O2 demand, reduces norepinephrine (Negatives: renal function need to be monitored, inflammation/pain)

    iv. Calcium channel blockers - lower bp.

    v. Nitrate

    vi. HMG CoA reductase inhibitors ie.Statins - lipid lowering meds (Negatives: use only if Cholesterol lowering meds have failed, contra-indicative in Diabetes, muscle pain, cognition loss, basically use it as last resort)

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