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Ischaemia : Case 5

MCE for detection of ischaemia

Patient Description

  • 80yr old patient with effort dyspnea, no chest pain
  • Hypertensive, type II diabetes
  • Normal resting ECG
  • Normal resting echocardiogram


Referred for stress echocardiography


 

MCE - REST images

 

Flash imaging at rest, normal replenishment within 5 cardiac cycles. See below for still images of this movie.

 

Contrast Echo Box : Atlas

A: Pre-flash Normal perfusion in all walls 

Contrast Echo Box : Atlas

B: Flash impulses to destroy contrast in myocardium

Contrast Echo Box : Atlas

C: Post flash myocardium is black due to bubble destruction

Contrast Echo Box : Atlas

D: Normal replenish-ment within 5 beats

 

MCE - STRESS images

 

Flash imaging after dipyridamole stress. Note the clear subendocardial perfusion defect - see below for the still images from this movie.

Contrast Echo Box : Atlas

Pre-flash normal perfusion in all walls

Contrast Echo Box : Atlas

High MI flash frames

Contrast Echo Box : Atlas

Post-flash frame confirming good bubble destruction

Contrast Echo Box : Atlas

Extensive perfusion defect (delayed refilling) extending from mid-apical septum through entire lateral wall