Coronary Flow Velocity Reserve and Myocardial Contractility Under Stress in the Post-Infarction Ischemic Memory Dilemma

Introduction

After acute myocardial infarction (AMI), some cases progress with deep T wave inversions on electrocardiogram (ECG). This electrocardiographic abnormality can continue for a prolonged period, even if a coronary intervention within a short time of AMI progression results in successful myocardial reperfusion. However, these deep T wave inversions can raise management questions when the patient is already being followed up in an outpatient clinic, particularly in the absence of relevant symptoms to support the resurgence of an ischemic process. In this context, a safe noninvasive assessment such as dobutamine stress echocardiography (DSE) associated with the analysis of coronary flow velocity reserve (CFVR) may be an option for this dilemma between myocardial ischemia and the possible post-infarction ischemic memory. ^–

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