A computed tomography (CT) coronary angiogram (CTA) was performed, as the patient was not keen on an invasive angiogram, and demonstrated sub-endocardial hypoattenuation at rest in the anterior wall, apex and apical inferior walls (figure 1B). It was not clear if there was any reversible ischaemia so a myocardial perfusion scintigraphy (SPECT) was performed, and demonstrated a partial thickness infarction involving the anterior wall, apex and apical inferior wall (figure 1A). A research cardiac magnetic resonance (CMR) scan demonstrated late Gadolinium enhancement in the same territories as the other two studies (figure 1C).
Figure 1. A. Myoc