case_images: PMC4008276_01
case_images: Scheme of "fast" protocol with dipyridamole for evaluating CFR and regional wall motion according to the recommendations of the European Association of Echocardiography.
case_images: CRIM.CARDIOLOGY2013-343027.001.jpg
case_images: PMC4008276_01_CRIM.CARDIOLOGY2013-343027.001.jpg
case_images: fig1
case_images: In December 2010, she underwent a pharmacologic stress echocardiography with dipyridamole (0.84 mg/Kg in 6 minutes, "fast" protocol) to evaluate at the same time the coronary flow reserve (CFR) and the regional wall motion according to the stress echo recommendations of the European Association of Echocardiography (Figure 1).
case_images: Surface ECG performed at the high-dose dipyridamole during stress echocardiography, showing a clear depression of the antero-septal ST segment. At the same time the patient referred angina pectoris.
case_images: CRIM.CARDIOLOGY2013-343027.002.jpg
case_images: PMC4008276_01_CRIM.CARDIOLOGY2013-343027.002.jpg
case_images: fig2
case_images: In the presence of angina pectoris and significant repolarization phase abnormalities of the surface ECG (Figure 2) the stress echo showed an impaired CFR (<2) (Figure 3) without regional wall motion alteration.
case_images: High-dose dipyridamole induced CFR during the same stress echocardiography of Figure 2.
case_images: CRIM.CARDIOLOGY2013-343027.003.jpg
case_images: PMC4008276_01_CRIM.CARDIOLOGY2013-343027.003.jpg
case_images: fig3
case_images: In the presence of angina pectoris and significant repolarization phase abnormalities of the surface ECG (Figure 2) the stress echo showed an impaired CFR (<2) (Figure 3) without regional wall motion alteration.
case_images: CFR evaluation after 6-month therapy with ranolazine.
case_images: CRIM.CARDIOLOGY2013-343027.004.jpg
case_images: PMC4008276_01_CRIM.CARDIOLOGY2013-343027.004.jpg
case_images: fig4
case_images: Again in the absence of regional wall motion abnormalities, the test showed a completely normal CFR with a relevant improvement in comparison with the previously performed test (from 1.85 to 4.00) (Figure 4).
case_images: Surface ECG performed at high-dose dipyridamole during stress echocardiography after 6-month therapy with ranolazine. At the same time the patient was completely asymptomatic.
case_images: CRIM.CARDIOLOGY2013-343027.005.jpg
case_images: PMC4008276_01_CRIM.CARDIOLOGY2013-343027.005.jpg
case_images: fig5
case_images: Of interest, the patient did not exhibit any kind of symptoms during and after the stress echo and the surface ECG was totally normal (Figure 5).