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A 57-year-old man with a history of hypertrophic cardiomyopathy diagnosed by echocardiography experienced atypical chest pain and dyspnea for 6 months. A rest 99mTc-MIBI myocardial SPECT imaging and a 18F-FDG myocardial PET/CT imaging were performed, which showed multiple matched myocardial perfusion/metabolism defects in the left ventricle, indicating scar tissue. Surprisingly, subsequent contrast coronary angiography revealed no significant coronary artery stenosis.

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