Is a grade 1 mild reversible defect in the anterior apical segment of the left ventricle considered an area of ischemia?

Submitted by Elizabeth from Phoenix, Arizona

by Jose Diez, MD 

Yes, in general a reversible defect is considered to be ischemic. However, it needs to be placed in the patients clinical context. It may not be clinically significant if the patient is at low risk for cardiovascular events given an absence of major risk factors (HTN, HLD, DM, smoking, family history of premature CAD). Also if the patient does not have any significant symptoms.

It is recommended that medical therapy be used first for these kind of small defects, reserving an invasive strategy (cardiac catheterization) for moderate to severe defects associated with symptoms or other high risk variables.