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Short axis MRI images of a 75-year-old male patient with an old myocardial infarction and chest pain in the emergency room show thinning of the anterior septal wall with decreased first pass perfusion at adenosine stress (a), which persists at rest (b). On delayed enhancement imaging the scar (c) matches the fixed first pass perfusion defect. The MRI findings match the SPECT findings at stress (d) and rest (e).
