Figure 2
Representative images from PYP and CMR; (A) PYP showed significant uptake in the inferior and apical walls including the right ventricle (yellow arrows); T2-weighted CMR image showing (B) high signal intensity in the inferoseptal wall and right ventricle (arrows); delayed enhancement was observed in the area with myocardial infarction (C) (arrow heads).
Representative images from follow-up coronary angiography with acetylcholine provocation test and OCT of the RCA; coronary angiogram (arrow heads indicate the right coronary artery; arrows indicate the left anterior descending artery) showing (D and E) non-occlusive coronary arteries at baseline and (F and G) total occlusion upon intra-coronary acetylcholine infusion; (H) OCT of the RCA showing extensive, homogenous bright intimal thickening (yellow arrows) without prominent attenuation, suggesting fibrotic change.
Abbreviations: Ach, acetylcholine; OCT, optical coherence tomography; RCA, right coronary artery; PYP, 99mTc-pyophosphate scintigraphy; CMR, cardiac magnetic resonance imaging.