Fig. 3

Asymptomatic male patient with type 2 diabetes mellitus who was actively hiking. This patient was recruited into our study and had a positive screening stress cardiac magnetic resonance. Top row of images show stress perfusion defects (red arrows) in the basal, mid-ventricular and apical slices in the left anterior descending (LAD) territory as well as a stress perfusion defect in the left circumflex (LCx) territory on the basal slice in the inferolateral wall (red arrow). These perfusion defects resolved on the rest images. The catheter coronary angiogram showed chronic total occlusion of the LAD (yellow arrow) and obstructive CAD of the LCx (yellow arrow). Fractional flow reserve measurements of the LCx was 0.69. Post-stenting image in the bottom right shows the re-perfusion of the LAD and expansion of the LCx narrowing