Fig. 6

A 75 year-old male with hypertension and hyperlipidemia reported exertional dyspnea during rehabilitation post-stroke. Transthoracic echocardiography (TTE) showed mild left ventricular (LV) systolic dysfunction, and he had difficulty walking. Given concern for myocardial ischemia, he was referred for CMR with stress. Late gadolinium enhancement (LGE) demonstrates a small subendocardial infarct in the basal inferior wall, while myocardial perfusion acquired during adenosine infusion (stress) shows extensive perfusion abnormality that mostly resolves on resting perfusion imaging. Cine CMR demonstrates mild segmental LV dysfunction. These findings prompted invasive coronary angiography that showed high-grade multivessel coronary artery disease (CAD); post-revascularization, functional capacity improved