Impression:
Marked reduced uptake in the inferior and inferolateral walls at rest (white arrows) with mild transient changes at the edges (white small lines) -- consistent with transmural MI and mild peri-infarct ischemia (RCA territory).
Mild reduced uptake in the anterior and anterolateral walls at rest (blue arrows) with severe stress-induced changes (blue small lines) -- consistent with nontransmural MI and severe ischemia in the residual myocardium (LAD-LCx territories).
Marked stress-induced changes in the apex (blue small lines) -- consistent with severe ischemia.
Total ischemic volume is in the order of 60% (sic) of total myocardium.
Very little late fill-in, only a few segments apical anterior and inferior laterally (green small lines) show signs of hibernating myocardium.
Same day RVG (ECNA=MUGA) shows borderline global systolic LV function (LV EF) 52%.
Coronary angiography:
Severe triple-vessel disease, none of which are accessible for CABG or PTCA
