Figure 5From: Real-time cine and myocardial perfusion with treadmill exercise stress cardiovascular magnetic resonance in patients referred for stress SPECTIschemia by Treadmill Stress CMR Not Evident by SPECT. Rest and stress images show ischemia by CMR not evident by SPECT in a 56 year-old male with known coronary artery disease was referred for stress testing to evaluate abnormal stress ECG done prior to starting a supervised exercise program. Exercise-induced ischemia is evident by ST depression on electrocardiography (A-rest, F-stress), lateral wall motion abnormality on end-systolic frames from cine CMR (B-rest, G-stress) and lateral perfusion abnormality on first-pass contrast enhanced CMR (C-rest, H-stress). No myocardial infarct scar was seen by LGE CMR (E). SPECT images obtained during the same stress examination suggest normal myocardial perfusion (D-rest, I-stress). Invasive angiography (J) identified high-grade ostial stenosis of a large ramus intermedius coronary artery leading to percutaneous coronary intervention.Back to article page