Case presentation:

• Female.
• 63 y.o.
• Overweight, hypertension, dyslipemia, type II diabetes.
• Mild/moderate renal insufficiency.
• 2 acute episodes of pulmonary edema 8-3 months before.
• Presents with chest pain and weakness after mild exercise.
• The rest ECG was totally normal. -Medication: ARBS, diuretics, metformin, statins.

Teaching points:

• Myocardial viability assessment is indicated in patients with chronic LV dysfunction.
• In patients with LV dysfunction and myocardial viability, the mortality is significantly lower in those treated with revascularization than those treated medically.
• The extent of perfusion–metabolism mismatch is proportional to mortality rate in medically treated patients with chronic ischemic LV dysfunction.