Abstract
A 56-year-old man1–4 with a history of mild dyspnea for several years and without cardiovascular risk factors was referred to our institution for coronary angiography. Before he was admitted to the hospital, a transthoracic 2-dimensional echocardiogram (TTE) was performed. The TTE was not diagnostic enough because of a suboptimal acoustic window and a technetium-99m single photon emission computed tomography pharmacological (dipyridamole) stress test that showed a mild, reversible left ventricular septal perfusion defect. On admission to our institution, the patient was asymptomatic and had no signs of heart failure on physical examination; however, a mild systolic (grade 2) murmur was heard on cardiac auscultation. An ECG at rest showed a sinus rhythm with normal PR interval and complete left bundle-branch block …
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