what are implications of posterior wall damage to heart -is it repairable or can anything be done to correct?

Answer 1

You can possibly diagnose it with an EKG. There are 2 types of injury to the heart: ischemic, and cell death. Ischemic is irritation. That can most likely be repairable. If the injury causes cell death, that part of the heart will not work.

Answer 2

As you might imagine it depends on the degree of damage. You can have a transmural infarction (aka q-wave or STEMI) that indicates the entire thickness of the that area of the heart has died due to inadequate blood supply for a long enough to affect cell death.

There are non-q-wave infarcts that mean the entire thickness has not died. These types of infarcts are actually more common than the former type.

Immediately after an infarct, the heart will typically be stunned and will demonstrate significant wall motion abnormalities.

Over time (6 weeks to a few months), with re-vascularization (opening the culprit blocked artery with clot-busting medication or with angioplasty), optimal blood pressure (less than 125 sys) and rate control (60's), adoption of better habits (stop smoking) the heart with often "bounce back." Being on the right medications will also help - an ACE inhibitor and a Beta blocker at least, and possibly others depending on your particular needs.

This is typically measured in terms of ejection fraction (50-70% normal). EF's less than 50% indicate some dysfunction - the lower the number the worse it is. If your EF is less than 50% inquire about using Coreg. I have seen nearly miraculous response to this medication with improvement of EF even as good as back to normal. Even with damage, the other three sides of the heart will sometimes compensate.

Good luck. I hope this helps.