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. Author manuscript; available in PMC: 2009 Sep 30.
Published in final edited form as: Circulation. 2009 Mar 31;119(12):1671–1681. doi: 10.1161/CIRCULATIONAHA.108.816512

Figure 6.

Figure 6

CMR images from a patient with previous stents to the RCA and LAD 2 years earlier who presented to the emergency room with troponin-negative chest pain. CMR was performed within 24 hours of admission. Panel A shows inferior and anterior ischemia on adenosine-stress perfusion imaging. Panel B shows late gadolinium enhanced images with a region of subendocardial gadolinium enhancement in the inferior wall suggesting old myocardial infarction that was not previously known about. T2-weighted images were normal (not shown). Subsequent coronary angiography revealed tight in-stent restenosis in the RCA and significant flow-limiting disease in the LAD (panel C) as assessed by a pressure wire during hyperaemic conditions (fractional flow reserve 0.69). Both lesions were stented successfully and the patient was discharged home.