Figure 7

Example of a false positive SPECT with moderate ‘inducible ischemia’. (Ai-ii) MIBI bulls eye plots demonstrating a defect at stress in the basal to mid anterolateral wall (i) which appears fully reversible at rest (ii) with a SDS of 5 (iii) suggesting a moderate inducible perfusion defect. (Bi-iii) Basal, mid and apical short axis slices from stress CMR show visually normal perfusion in all territories. Quantitative perfusion (not shown) confirmed normal stress perfusion values at the sites of the defect seen on MIBI. (Ci-iii) Basal, mid and apical short axis slices from LGE stack demonstrate lack of any myocardial scar. (Di-ii) CT coronary angiogram performed in view of the discordance between SPECT and CMR shows that the coronary arteries are entirely normal.