Our expert says:
Thank you for your question.
As a general rule, any narrowing of an artery should be treated, either with a balloon or a stent, if the narrowing restricts blood flow. Usually it is clear from the angiogram whether a narrowing is severe enough to restrict blood flow, and narrowings of 70% or more should usually be treated. However sometimes the severity of a narrowing may be difficult to judge just from looking at the angiogram. If that is the case, the true significance of a narrowing can be measured using a technique called FFR, which involves measuring the pressures above and below the narrowing. These general rules apply at all ages, but there are of course other factors to bear in mind when deciding whether or not a narrowing should be treated, eg age, activity levels, whether or not the patient is diabetic, etc.
After a heart attack it is not the arteries which become dead, but the heart muscle which they supply, which may be temporarily or permanently damaged. The usual way to detect heart muscle damage is with a test called an echocardiogram, which is easy to do and not invasive. The echo can show areas of the heart muscle which are not contracting properly, and also enable cardiologists to calculate what is known as ejection fraction, which is done by measuring the area of the main pumping chamber when the heart is relaxed and again when it contracts. A normal ejection fraction is between about 45 and 70% (not 100%!) and please bear in mind that ejection fraction is subject to observer variation. Your cardiologist should be able to make these measurements for you and give you the information that you need.
I hope this is helpful.
Best wishes, JT
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