Small myocardial infarction with small -medium pharmacologically induced myocardial ischemia in that distribution. what are the the implications?

Reversible defect?: If you're describing what we term a "reversible defect", wherein the heart seems OK at rest and not OK when stimulated (by exercise or medication), then this would mean that area of the heart is still vulnerable to damage (heart attack). This needs to be addressed and treated. You may need cardiac catheterization to define the anatomy of the vessel supplying that area with blood.