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Figure 2 A, 12-lead ECG at rest and at dobutamine stress (30 µg/kg/min) of a 57-year-old male patient studied 14 months after Q wave inferior myocardial infarction. The patient developed ST segment elevation in the inferior Q leads (II, III, aVF) and concomitant ST segment depression in the high lateral leads (I, aVL) during stress. B, Stress and rest tetrofosmin SPECT myocardial perfusion images from the short-axis (SA), vertical long-axis (VLA) and horizontal long-axis (HLA) views of the same patient, demonstrating a fixed perfusion defect in the postero-inferior wall (arrows) without reversibility (no scintigraphic evidence of ischemia).