Fig. 7

Clinical case illustrating microvascular dysfunction. A 54-year-old female presenting with persistent chest pain without angina symptoms or ischemic ECG changes on the stress test. Coronary angiography revealed a right dominant system with catheter-induced vasospasm in the right coronary artery and evidence of microvascular dysfunction. Following a 10-min exercise CMR protocol with a 15-W resistance increase every 2 min, her heart rate increased from 56 to 130 bpm. Real-time tagging CMR images were acquired pre- and post-exercise in short-axis and 2-chamber views. Tagging line quality for all acquisitions in both views was excellent (score = 1), characterized by well-defined tagline patterns with clear differentiation between dark and bright lines. Post-exercise tag lines were markedly deformed. All images shown near end-systole. ECG electrocardiogram