Figure 2
Images of a 69 year old female with old myocardial infarction and associated thinning of the inferior wall. The patient was referred because of exertional dyspnea. In comparison to the resting perfusion study (a) the stress perfusion study revealed a near transmural (~75%) perfusion deficit in the septal wall (arrows in b). While demonstrating normal contraction under resting conditions (c) a new wall motion abnormality developed under adenosine stress (arrow in d). Invasive coronary angiography revealed a high grade stenosis of the middle segment of the LAD.