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.