Authors' Note: There is variability in patients' response to the development of blockages in the coronary arteries. Part of this is due to the gradual development of collateral arteries or side branches, which may mitigate the effect of the obstructions to produce chronic symptoms or acute severe damage to heart muscle. The net impact on flow can be assessed through imaging showing blood flow to heart muscle at rest and stress, with nuclear or other studies of myocardial perfusion (‘gated SPECT’).
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