What can cure inducible ischemia?

My wife has inducible ischemia seen in anterior and anterolateral walls. Can we cure it using medicine or is angiogram the only option?

Submitted by Murugan from Bangalore on 09/07/2014

by Domingo G. Gonzalez, Jr., MD

A stress test that is consistent with inducible ischemia is a diagnostic tool. It predicts with approximately 75- 90% sensitivity and specificity if a patient with an intermediate risk for coronary artery blockages has blockages of greater than 70% in major arteries. Once this is done, if the test indicates blockages (inducible ischemia), then a decision needs to be made to confirm the findings and document the presence or absence of blockages. This can be done noninvasively with a CT coronary angiogram, or invasively with a heart catheterization and coronary angiogram. If the ct angio is positive, then an invasive coronary angiogram would be indicated to see if the patient needs stents or bypass surgery. All these are tests and not treatment.

All patients benefit from medicines and there is an indication for certain medicines, e.g., aspirin, statins, beta blockers and ACE inhibitors in all patients with coronary blockages, whether they undergo stent placement or bypass surgery because the underlying disease is still there. Beta blockers are medicines that can decrease the inducible ischemia; stent placement and coronary artery bypass do as well. The decision tree can be complex and should be considered and discussed with a qualified cardiologist.