A Reminder That Stress Echocardiography Is Useful in Diagnosing Myocardial Ischemia in Nonobstructive Coronary Artery Disease: Case Series

Figures

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  Figure 1. Stress echocardiogram from clinical case 1 (A) Standard parasternal long-axis views of the left ventricle showing baseline, low dose, and peak dose followed by recovery images. (B) Standard short-axis views of the left ventricle showing the same test phases as in the previous. In this set, please note that the arrow demonstrates a lack of contractility of the inferior wall in this view. Inferior wall contractility improves in the recovery images. (C) Standard four-chamber apical views of the left ventricle showing the same test phases as in the previous. (D) Standard two-chamber apical views of the left ventricle showing the same test phases as in the previous. Once again, in this set, please note that the arrow demonstrates a lack of contractility of the inferior wall. Once again, inferior wall contractility does improve in the recovery images

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  Figure 2. Coronary angiogram from clinical case 1 (A) Standard angiographic view of the right coronary artery and (B) the left coronary artery system from clinical case 1

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  Figure 3. Stress echocardiogram from clinical case 2 (A) Standard parasternal long- and short-axis views of the left ventricle both at rest and post-exercise using a treadmill stress echo protocol. Please note that the black arrows demonstrate the lack of contractility of the anteroseptal and anterior walls at peak exercise. (B) Standard four- and two-chamber apical views of the left ventricle showing the same test phases as in the previous. Please note that the black arrow demonstrates the lack of contractility of the distal inferoseptal wall. The white arrow shows anterior wall ischemia at peak exercise

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  Figure 4. Coronary angiogram from clinical case 2 (A) Standard angiographic view of the right coronary artery and (B) the left coronary artery system from clinical case 2

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  Figure 5. Stress echocardiogram from clinical case 3 (A) Standard parasternal long-axis views of the left ventricle showing baseline, low-dose, and peak-dose followed by recovery images. Please note that the white arrow shows a lack of contractility of the anteroseptal wall. Contractility does not improve in the recovery images. (B) Standard short-axis views of the left ventricle showing the same test phases as in the previous. Please note that the white arrow shows a lack of contractility of the anterior wall and contractility does not improve completely in the recovery images. (C) Standard four-chamber apical views of the left ventricle showing the same test phases as in the previous. (D) Standard two-chamber apical views of the left ventricle showing the same test phases as in the previous. Please note that the white arrow shows a lack of contractility of the anterior wall and contractility does not seem to improve in the recovery images

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  Figure 6. Coronary angiogram from clinical case 3 (A) Standard angiographic view of the right coronary artery and (B) the left coronary artery system from clinical case 3