This case is all on video, click here to view it (it is a large file and you may prefer to download it after clicking on this link). It shows a coronary angiogram with subtotal occlusion of the origin of the superior interventricular artery ("LAD"). There is hardly any contrast flowing down it at all. There is some feeble collateralisation from the right coronary artery, mainly from a right superior septal perforator ( an unusual vessel, passing leftwards from the right coronary sinus). Despite this, the contractility of the superior LV wall is almost normal. This case shows that the LV can still function on minimal perfusion (see the section on "the ischaemic cascade" in the Presentations).