Q: I am a 71 years old man who underwent a coronary artery bypass grafting (CABG) 15 years back when my 5 arteries were blocked. I have high blood pressure too and am taking Amloz and Eltroxin as I underwent a surgery for removal of the thyroid gland 17 years back. Eight years back I developed enlarged prostate and am on Haitrin daily. I am on a catheter now due to the difficulty in passing urine. My PSF is 11 and the urodynamic test confirmed surgery of the gland. I underwent a stress thallium test and the report showed consistent with ischaemia in apico inferior and lateral walls. What does this mean? Can I go ahead with surgery or an angiography is required with angioplasty? What should I do? Please suggest.

A:Stress Thallium showing ischaemia in apico inferior and lateral walls suggests that there is lack of blood supply in these areas of the heart and therefore either there are blockages in the grafts which were placed during your bypass surgery or the native disease has progressed. Generally in such situations coronary angiography is recommended. However, we cannot give specific answers without access to complete clinical details and the benefit of physical examination of the patient. I think, your being in touch with your doctor is the right approach and a worthwhile second opinion cannot be given based on cursory details.