What are the consequences of having a small area of ischemia at the apex of the left ventricle?

Depends: I suppose that was a conclusion from a nuclear stress test? 1) it maybe an artifact, so called false positive test. 2) if its real, a lot depends on presence and severely of your symptoms.

Depends: Small ischemia at the apex could be caused by a variety of different lesions in the blood vessels of the heart. The next step in defining your consequences is to define the anatomy of your heart vessels with dye and determine if and where there is blockage. The specific location and length of blockage (s) will define your consequences.