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. 2022 Jan 13;24:9. doi: 10.1186/s12968-021-00842-0

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© The Author(s) 2021

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

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Fig. 2 — Stress perfusion-CMR in a permanent pacemaker dependent (PPM) patient. A 74-year-old man was referred to stress perfusion CMR due to exertional dyspnea and angor. A double chamber PPM was implanted for a 2-degree atrioventricular block and the patient was PPM-dependent (Panel A). X-ray coronary angiography showed a severe stenosis of the proximal portion of the left anterior descending artery (Panel B, C, yellow arrowed) that was treated by drug-eluting stent implantation. Stress perfusion CMR, performed before x.ray coronary angiography showed an extensive hypoperfusion in the anterior and septal wall (Panel D–G, red arrowed) without the presence of myocardial scar in late gadolinium (LGE) images (Panel H, I, L, M) indicating a positive stress test, consistent with the lesion found in x-ray coronary angiography