Make the Diagnosis: CAD Concerns

Presentation

Case Findings: A 75-year-old male with a history of coronary artery disease status post stenting of the LAD presents with new onset chest pain that has been ongoing for the last two months. The pain is exertional in nature, improving with rest and nitroglycerin. He states having been compliant with his medication. A pharmacological nuclear stress test is ordered.

The findings are most consistent with which condition?

Learnings

Correct Answer:

E. Multivessel disease. There is a global decrease in intensity in the stress images as opposed to the rest images. Transient ischemic dilatation is also present. Finally, there is a large perfusion defect in the left circumflex distribution. Taken together, these findings point towards multivessel disease. This patient required bypass surgery following repeat angiography that showed multivessel proximal disease.

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Make the Diagnosis: CAD Concerns