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Ischaemia : Case 1

Patient Description

Patient with an episode of chest pain, no significant Troponin increase at 12hours and no significant ECG abnormalities.


 

Stress echocardiogram

  • At stress Normal WM but delayed replenishment after flash (3-4 cycles) in the apex
  • Perfusion defect is more evident in 2-chamber view (anterior segments also)
  • The basal lateral segment was in this case considered non interpretable due to attenuation artefact

 

Contrast Echo Box : Ischaemia

WM at Stress-LVO settings
4-chamber view

WM at Stress-Perfusion settings
4-chamber view

Contrast Echo Box : Atlas Contrast Echo Box : Atlas Contrast Echo Box : Atlas

Perfusion at Stress
4-chamber view

Perfusion at Stress
4-chamber view

Perfusion at Stress
4-chamber view

Coronary Angiography

RCA

 

 

LCA

 

 

 

Mid LAD 70% stenosis & Circumflex 70% stenosis.
In this case perfusion helped and the diagnosis (significant CAD) could be done by perfusion only (apex) and not Wall Motion