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Condition of heart, arteries in MRI with smoking?

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This is for my father who is aged 74 and lives in India, and have been smoking for more than 50 years. We have got all the required test (MRI etc) done and are attached here.

My questions are:

1. the condition of his heart and arteries (are they blocked), can it cause heart stroke soon
2. Any lung issues visible in the tests

MAsood([email protected])

Category: Cardiologist

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Category: Cardiologist
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I have analyzed your Dad's history and yet it seems there is some amount blockage of arteries. But it is hard to tell whether it is a significant block that can cause heart attack with the available information. The ECHO and ECG studies do not show any significant danger as of now, which is a good sign. I would like to know the clinical condition of your father. Does he have any chest pain? Any breathlessness or increased sweating ? Does he have diabetes / high blood pressure ? Is he obsese ?
Mostly he would require a coronary angiogram considering his history of smoking. I would be able to comment on this once you reply to my questions. Coronary Calciums scan is a not a fool proof test and it often cannot give the complete picture.
There are some lung findings but mostly related to the smoking and aging - this as of now should not be a concern.
Thank you

Patient replied :

Hello Dr. Mahajan,
Thank you for your response and detailed information.
My dad does not have any other problem that you mentioned like - no BP problem, no chest pain or sweating, no diabetes, and he is not obese. He sometimes feel breathlessness only when he is walking long distance or going upstairs.
2-3 months back he had a chest pain and that was due to gas with no sweating or breathlessness.
We showed this report to the doctors they said his 2 arteries are blocked by >90%. Could you please confirm if his two major arteries Left and Right have any blockages or not.
Do we need to get coronary angiogram done?
Thank you so much for you time and expert advice.

Hello Masood,
It is better to get a coronary angiogram done , in consult with a Cardiologist as it is a safe and simple procedure. As mentioned there are blocks in the artery, but I cannot say whether its "90%" or not. The reason being the only absolute way to know about the blockage is to get anngiogram done, which will visualise the arteries and give us a better pictures.
It's good to know that your father does not have any other symptoms or risk factors. Smoking cessation is strongly suggested.
Over all I would advice caution and further evaluation in view of the test results. Hope this helps
Feel free to ask followup questions, I will be more than happy to help
Thank you

Dr. Vivek Mahajan
Category: Cardiologist
Fellowship: DM, Cardiology, PGIMER, 2013
Residency: MD, Internal Medicine, AIIMS, 2007
Internship: King Edward Memorial (KEM) Hospital, 2003 
Medical School: MBBS, Seth G.S. Medical College, 2002
Dr. Vivek Mahajan and 4 other Medical Specialists are ready to help you

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