Figure 7

First-pass myocardial perfusion CMR was performed in a 75 year-old male with a history of bypass surgery seeking a second opinion regarding intervention for bypass graft disease. Perfusion images obtained during intravenous infusion of adenosine (A) demonstrates diffuse subendocardial perfusion abnormality not present on resting perfusion imaging (B). Late gadolinium enhancement acquisitions (C) show a small region of enhancement involving the lateral wall. Together, these findings suggested prior infarct with ischemia. His symptoms were controlled with optimization of anti-anginal medical therapies. (See Additional file 3.)