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46 years old woman with atypical chest pain,Exercise test- negative for ischaemia

LM and LAD flow seems to be OK. Does "avi 13" clip show LCX flow?

avi 9: Is this coronary artery loop (tortuosity) or myocardial bridging?

PPT<15%
What was the purpose of the exercise test?

To exclude m.ischaemicus cordis.Diagnostic was interfered with chronic,heavy alcoholic abuse,dipsomania, I think.

LAD prox course stumbling in the stone

Aherosclerotic plaque in LMCA ?

Pawel Hertz писал(а): ↑

Чт авг 23, 2018 9:04 am

Aherosclerotic plaque in LMCA ?

Collaterals in apex ?

This stone seems to do no harm,non obstructive lession on a course of LAD.Incydentaloma,but interested.
LMCA ostium is in inferior tilt,that it makes a possibility of coronary anomalous thinking ,but it is not.
Unfortunately sudden death is that what she experienced.

RV and LV

PW-flow pattern from apex looks like fistulae

How do you think,in your eyes,looking at the pictures: Do the flows trigger steal phenomenon?
Coud you tell,without coronarography?
These smalls flames at the apex?
One should pay attention to the low Nyquist limit-40 cm/s

She had an atypical angina, of couse it maight be result of steal phenomenon.
Can I tell about this without agio? Yes, but i can't tell without stress-echo.
In my opinion we can suppose steal based on velocity in LAD and velocity and prolongation of the flow in fistule theoreticaly, but in similare case I will prefe more robust signs. Very intresting question and I pass the floor to you.

As I mentioned she died suddenly.
Corresponding article by Carvalho from 2014 year.
I think this suits the case.
Take home message->We see only "The peak of iceberg"

And some videos with stress and coronarography from this unique article

and others pictures from Carvalho