That heart specialist's reply came across to me as odd. Moldova isn't somewhere I know anything about, but the results show clear vessel trouble, likely from plaque and possibly an earlier event, yet nothing followed. What is everyday medical care like in that country? Are public options held back by funding shortages or does it run more on private payments? Either way, doing nothing for someone covering their own costs looks off. Sometimes holding off on extra scans fits if there is no chest pain during activity and results would not shift anything, though that only works if cholesterol meds and the like are already underway. Does a nearby physician handle regular visits? Sorting out sugar readings, blood fats, kidney performance, and pressure readings when they are off forms the biggest step in dealing with vessel trouble and keeping it from advancing further. Those checks can happen through a local physician. The pulse climbing at night suggests possible pauses in breathing during rest, so looking into sleep patterns plus wearing a monitor around the clock might clarify things. The hardened areas noted on the image, depending whether it was a targeted artery measurement or a broader scan, would confirm plaque in the heart arteries if it was the first type and call for action. Trying activity on a treadmill or ultrasound during effort could be a reasonable next step. Without details on age or other history or body size the lack of follow-up still does not fit. Handling what a local physician can cover first, like those blood checks plus pressure and fat treatment while confirming no diabetes, would cut most dangers substantially even when specialist access is limited by costs. Those injections for weight seem useful too when extra pounds are a factor.