Impression:
Fixed moderately reduced uptake in the lateral wall (white arrows) with minimal transient changes (small white lines) -- consistent with nontransmural MI (5/25 segments) with minimal ischemia in a small volume myocardium (1-2/25 segments of the myocardium) (LCX territory)
Fixed mildly reduced uptake in the inferior wall and posterior septum (green arrows) with mild transient changes (small green lines) -- consistent with nontransmural MI (7/25 segments) and moderate severe ischemia (4/25 segments) in residual myocardium (RCA territory)
LAD territory appears to be unaffected. The apical involvement is most likely due to wrap-around of LCX or RCA
Comment:
In this study, during Dobutamine infusion of gradually increasing doses, the blood pressure initially increased, but was followed by a significant fall.
This is a common phenomenon with Dobutamine stress protocols and does not carry the same significance as blood pressure fall during physical stress (see tutorial on "Stress Protocols - Dobutamine")
