The Role of Stress Echocardiography: Ischemia Evaluation and Beyond (Miguel Quinones, MD) 01/07/2020

[@handetureli7692]

perfect presentation, thank you !

[@cmh96]

Greetings Professor Quinones for the wonderful lectures throughout. In this lecture, you presented a case of abnormal segmental strain but normal angiogram and concluded that the strain is might not be that informative in IHD. To the best of my knowledge, coronary angiogram evaluates the epicardial vessels and gives no information on the microcirculation. I had a patient with metabolic syndrome and severe sleep apnea who presented with chest pain, significantly raised cardiac enzymes, normal ECG, Significantly abnormal segmental strain (the like you presented). Behold, normal angiogram. The entity is well known: Myocardial Infarction with Normal Coronary Arteries (angiogram) or MINOCA. I feel an abnormal segmental strain gives information beyond the normal angiogram. It gives information on the microcirculation which the angiogram does not. Also, a patient might have a myocardial disease but with normal coronary arteries. Of course, the strain might likely be altered. It will be nice to also confront the strain findings with standard methods of evaluating the microcirculation (echo CFR or FFR) and not the angiogram.
I shall be very pleased to write to you directly via e-mail for clarifications with some troubleshooting echos. I shall be pleased to have your e-mail. I am a fan of the Houston Methodist team: Wonderful lectures. I am an Internist in Cameroon. Central Africa.
Sincerely
Ahmadou M. JINGI.
MD, DES (Int. Med).
e-mail: [e-mail]

[@KPSinghCardiosonologist]

NICE