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Perfusion defect on CT coronary angiogram

Case contributed by Yune Kwong
Diagnosis certain

Presentation

Known coronary artery disease.

Patient Data

Age: 60-65 years old
Gender: Male

ECG-gated CTCA

ct

Curved MIP shows critical stenosis (C) in the proximal LAD. Further moderate-to-severe (M) stenosis in the mid-LAD. A stent (S) is also seen more distally.

Reconstructed images show sub-endocardial hypodensity (arrows), consistent with a resting perfusion defect in the LAD territory.

Catheter angiogram.

dsa

Catheter angiography confirms critical stenosis in the proximal LAD (arrow).

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