A 58-year-old with exertional chest discomfort undergoes gated myocardial perfusion SPECT. The rest study shows a fixed perfusion defect with akinesis of the anterior wall and mid septum, while the lateral and inferior walls show normal uptake and normal thickening. Which coronary artery territory best explains this regional wall abnormality?
Select an answer to reveal the explanation.
Short Explanation
Your finding points to the LAD territory, which usually supplies the anterior wall and much of the septum. It’s like matching a patch on a map to the artery that feeds it, though individual coronary patterns can vary.
Full Explanation
The anterior wall and much of the interventricular septum are typically supplied by the left anterior descending artery, so a fixed defect with akinesis in those regions best matches the LAD territory. The right coronary artery commonly supplies the inferior wall and right ventricle, while the left circumflex artery commonly supplies the lateral and posterolateral walls; those regions are described as normal here. Left main disease can affect multiple left ventricular territories through its branches, rather than specifically explaining this localized pattern. Coronary dominance and individual anatomy can alter perfusion territories, so the findings should be interpreted with the images and clinical context.