Impression:
Severe stress-induced changes in the lateral wall from the base to the apex (small lines) -- consistent with severe ischemia (5/25 segments; about 20% of the total myocardial volume) (LCX territory).
Quantification shows that 19% of the myocardium is involved. The severity score is high (499). The quantification also shows a rest perfusion abnormality in the inferior-lateral wall which is not appreciated in the images. A minor injury is therefore possible but not proven.
There appears to be a significant increase in LV cavity size in the stress study.
This is partly due to suboptimal alignment and partly to the severe ischemia in the lateral wall. Still, even considering the above, the cavity size does appear to increase, thus indicating subendocardial ischemia, reasonably secondary to LV failure and associated increase in LV EDP.
Coronary angiography:
LAD - 30-40% proximal stenosis
- - 1st marginal branch - 40% proximal stenosis
