Ischaemia : Abnormal Example

AP4C	AP2C	AP3C

Note: At peak stress, widespread perfusion defects in all apical segments, septum and anterior wall despite only the apical septum being hypokinetic.

AP4C	AP2C	AP3C

Note: These are still frames from 1 second after flash destruction. Note the heart rate of 122-126bpm. The yellow arrows depict clear perfusion defects in all three apical views.


Note: Thus by wall motion criteria, there was only 1/17 ischaemic segments (apical septum) But by perfusion, there were 6/17 ischaemic segments (true apical cap, apical septum, apical lateral, apical inferior, apical anterior and mid anterior) Coronary angiography revealed an entirely occluded LAD coronary artery, thus proving the incremental value of MCE over wall motion in this case