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Figure 3 Irreversible perfusion defect obtained from a 78-year-old female patient, with her typically severe cavity obliteration and apical hypertrophy exhibited in Figure 1. In exercise thallium single photon emission computed tomography (201Tl-SPECT), there was a perfusion defect during exercise in the apical portion, which persisted up to 3 h later. The left ventriculogram displayed a spade-shaped deformation during diastole because of predominant apical hypertrophy. During systole a cystic cavity in the apical portion (arrow) was separated from the basal cavity by fairly long cavity disappearance, not mimicking hourglass. This cavity deformation suggests apical cavity obliteration with apical aneurysm rather than midventricular obstruction.
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