271e Atlas of Noninvasive Imaging

Question 1

A 48-year-old man with new-onset substernal chest pain. Echocardiography shows evidence of acute anterior myocardial infarction involving the interventricular septum and apex secondary to an occlusion of the _______

Answer 1

Left anterior descending artery

Question 2

A 55-year-old man with exertional chest discomfort and dyspnea. He exercised for 12 min on a standard Bruce protocol, experiencing typical chest pain and ST-segment depression in V2–V5. End-systolic frame of a stress echocardiogram shows apical four-chamber view at rest (left) and after exercise (right). After exercise, there is a clear regional wall motion abnormality in the distal septum through the apex, consistent with a stenosis in the_____

Answer 2

Left anterior descending artery

Question 3

Stenosis grading

Answer 3

normal
minimal (1–24%)
mild (25–49%)
moderate (50–69%)
severe (70–99%)
occluded (100%).

Question 4

A 34-year-old woman with known cardiac murmur and syncope with a family history of sudden cardiac death. Echocardiogram shows classic findings of marked left ventricular wall thickness, particularly in the interventricular septum, notable in the parasternal long-axis view and apical view. Reverse septal curvature in the apical view. There is substantial flow acceleration through the left ventricular outflow tract with evidence of a late peaking systolic gradient caused by outflow tract obstruction

Answer 4

Hypertrophic cardiomyopathy

Question 5

It is a progressive condition that has varying degrees of hemodynamic conse- quences due initially to the collection of pericardial fluid and ultimately to pericardial constriction. It is typically suspected in cases where pericardiocentesis fails to normalize intracardiac pressures.

Answer 5

Effusive-constrictive pericarditis