An Incidental Discovery or an Impending Disaster in a Patient With Coronary Artery Disease?

Abstract

A 52-year-old Native American man with a history of hypertension, hyperlipidemia, and tobacco abuse presented with C6-7 myelopathy for cervical fusion. A review of systems revealed a history of chest tightness with exertion for which he underwent a preoperative cardiac evaluation. A nuclear stress test revealed a subtle reversible defect in the basal anterior wall of the left ventricle (LV) and a moderate-sized fixed defect in the basal and midinferior walls of the LV, with a possible localized pericardial or pleural effusion.