NucMed Boards Prep
IMAGE INTERPRETATION · CARDIAC IMAGING

Reversible Lateral Wall Defect: Circumflex Ischemia

Myocardial perfusion SPECT — lateral wall defect present at stress, resolved at rest
Myocardial perfusion SPECT — lateral wall defect present at stress, resolved at rest

CC BY-SA 4.0 · Wikimedia Commons · source file

Question

This MPI SPECT shows a lateral wall perfusion defect visible at stress that fills in (resolves) on the rest images — a reversible defect. The lateral wall of the left ventricle is supplied primarily by which coronary artery?

  1. ALeft anterior descending artery (LAD)
  2. BRight coronary artery (RCA)
  3. CLeft circumflex artery (LCX)
  4. DPosterior descending artery (PDA)
Show the answer and explanation

C. Left circumflex artery (LCX)

The lateral wall of the left ventricle (including the lateral free wall and posterolateral wall) is supplied by the left circumflex artery (LCX). A reversible lateral wall defect on MPI suggests stress-induced ischemia in the LCX territory. The LAD supplies the anterior wall and apex. The RCA supplies the inferior wall (and posterior wall in right-dominant systems). The PDA (usually from RCA in right-dominant systems) supplies the posterior interventricular septum.

More cardiac imaging images

Myocardial perfusion SPECT — polar map (bull's-eye plot)Bull’s-Eye Polar Map: What the Center Shows Myocardial perfusion SPECT — anteroapical fixed perfusion defectAnteroapical Fixed Defect: LAD Infarction on MPI Myocardial perfusion SPECT — lateral wall stress/rest defect comparisonTransient Ischemic Dilation (TID) on Gated SPECT Myocardial perfusion imaging — stress and rest SPECT imagesRb-82 PET Perfusion and the Sr-82/Rb-82 Generator Myocardial perfusion scan — potential attenuation artifact in female patientBreast Attenuation Artifact on Myocardial Perfusion SPECT Cardiac SPECT with and without attenuation correctionCT Attenuation Correction Misregistration in Cardiac SPECT
← Fixed Perfusion Defect: Myocardial Scar on SPECTBull’s-Eye Polar Map: What the Center Shows →

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