My MIBI scan shows ischemia. Can I have a heart attack?

Question

Hello doctor,

I am a 42-year-old female. Last year, my GP recommended me for the MIBI (myocardial perfusion imaging) cardiac scan, and it turned out that I have mild anterior wall ischemia (10% total ischemic burden). He then recommended me for the angio scan, and the result came back normal.

He advised me to ignore the MIBI test result, as the angio scan came back normal. I would like to have a second opinion, as I cannot understand why he ignores the MIBI scan.

Can you please explain which test I have to trust, as I am worried sick and constantly afraid that I will have a heart attack? I am currently on Clopidogrel.

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I have seen the reports (attachment removed to protect patient identity).

Myocardial perfusion imaging showed mild ischemia involving 10% of the myocardium, not a large area. Coronary angiography came out normal, which means all major vessels are normal. There are two possibilities for ischemia. Vessel obstruction is at the microvascular level, and ischemia is there but is irreversible.

I want to see your MPI report to know whether ischemia is reversible or not, which area it involves, and what the cardiac function is. Also, send me echocardiography or other tests done, including angiography.

After seeing all reports and after your history, I can guide you better. Tell me, what symptoms do you have? Do you have hypertension, diabetes mellitus, kidney or thyroid disease, etc.?

I hope this helps.

Answer 2

Hello,

Welcome back to icliniq.com.

Your Tc99 myocardial perfusion imaging is normal (attachment removed to protect patient identity), and there was no chest pain and no significant ECG (electrocardiography) changes. CTCA (coronary angiography) is also normal with a zero CAC (coronary artery calcium) score. This is all normal. Since you have protein S deficiency, you will be at increased risk since your blood tends to clot easily.

So you have to live an active life, avoid sedentary behavior, avoid fatty foods and junk foods, and adopt a Mediterranean diet. I do regular exercise and avoid anxiety and depression. Protein S deficiency may cause the development of blood clots in veins rather than arteries, so your lower limbs and lungs are susceptible to clots. Therefore, you should avoid a sedentary life. Blood thinners are not indicated unless you have prolonged air travel, surgery, or pregnancy.

I hope this helps.

Answer 3

Hello,

Welcome back to icliniq.com.

There is only mildly reduced tracer uptake and not an area of necrosis, and it can occur with increased heart rates in anyone. Chances of heart attack are very low (equal to the general population of your age and ethnicity). General measures to prevent any cardiac event are the same as for the general population.

I hope this helps.