Impression:
No fixed or reversible perfusion abnormalities detected at the high cardiac workload achieved.
Moderate-to-marked increase in LV volume.
Increase in LV cavity size with stress suggestive of global (diffuse) subendocardial ischemia (arrow with cross).
ECHO:
Mild concentric LV hypertrophy with preserved systolic function.
Comments:
Possible explanations for the above combination of findings:
Toxic cardiomyopathy (ethanol) with myocardial dysfunction and elevated end diastolic pressure (EDP) during stress leading to subendocardial ischemia.
Small-vessel disease and secondary myocardial dysfunction, leading to subendocardial ischemia.
Hypertension (LV hypertrophy and subendocardial hypoperfusion during stress).
