Hello doctor, I am a 57 year old male, and I had episodes of shortness of breath and tachycardia, six months back. I take high doses of Statin and ACE inhibitors from ten years, and my lipid profile is excellent. EKG showed slight ST depression, an echocardiogram showed WMA (wall motion abnormalities), and the angiogram showed moderate coronary artery disease (CAD) in LAD, about 50% at first septal branch. LVEDP is 4 mmHg, no aortic pullback, and no mitral gradient. The diagnosis is nonobstructive coronary artery disease, and when I pressed for the etiology of symptoms, I was told it was due to a mild developmental disorder. After six months of weight loss, diet changes, exercise, etc., my symptoms have improved, but are still evident. How is LVEDP of 4 mmHg concordant with diastolic dysfunction? What else could be causing the symptoms, since CAD is nonhemodynamic?
Hello. Thanks for providing a detailed explanation. Revert with more information to a cardiologist online -->