Acute echocardiographic changes during percutaneous coronary angioplasty and their relationship to coronary blood flow

We describe a patient with angina pectoris and proximal left anterior descending coronary artery stenosis who underwent percutaneous coronary angioplasty, with simultaneous M-mode echocardiographic, hemodynamic, and coronary sinus-great cardiac vein flow measurements. An early diastolic septal wall notch of unknown significance was noted on the echocardiogram very early during balloon occlusion. It persisted even after release of balloon inflation, and lasted several beats after the return of great cardiac vein flow and hemodynamic parameters to baseline.