A 52-year-old man presented after one episode of effort angina, normal treadmill-ECG and clearly positive adenosine cardiac magnetic resonance (aCMR) for reversible perfusion defects in the left anterior descending coronary artery (LAD) territory. Contrast high-dose dipyridamole (0.84mg/kg/6min) stress-echocardiography (cSE) demonstrated normal myocardial perfusion and wall motion at rest, while perfusion defects were shown in the lateral and apical segments after dipyridamole. Wall motion at stress was completely normal and stress/rest Doppler diastolic velocity ratio on the LAD demonstrated reduced flow reserve. In this case cSE was the provocative test detecting both the LAD and circumflex obstructive lesions, thanks to myocardial perfusion analysis, while wall motion assessment was negative, not differently from treadmill-ECG, and aCMR highlighted only the LAD disease.
The dilemma of ischemia testing with different methods
DONATACCIO, Maria Pia;
2014-01-01
Abstract
A 52-year-old man presented after one episode of effort angina, normal treadmill-ECG and clearly positive adenosine cardiac magnetic resonance (aCMR) for reversible perfusion defects in the left anterior descending coronary artery (LAD) territory. Contrast high-dose dipyridamole (0.84mg/kg/6min) stress-echocardiography (cSE) demonstrated normal myocardial perfusion and wall motion at rest, while perfusion defects were shown in the lateral and apical segments after dipyridamole. Wall motion at stress was completely normal and stress/rest Doppler diastolic velocity ratio on the LAD demonstrated reduced flow reserve. In this case cSE was the provocative test detecting both the LAD and circumflex obstructive lesions, thanks to myocardial perfusion analysis, while wall motion assessment was negative, not differently from treadmill-ECG, and aCMR highlighted only the LAD disease.
I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
