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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


WM at Stress-LVO settings 4-chamber view	WM at Stress-Perfusion settings 4-chamber view


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

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Ischaemia : Case 1

Patient Description

Stress echocardiogram

Coronary Angiography

RCA

LCA