Cardiovascular
Case 1
Indication: Myocardial Perfusion & Function Study (MIBI)
To evaluate Myocardial Ischaemia
75 yr old man presents with recurrent chest pains with multiple risk factors: smoking, hypertension, hyperlipidaemia & NIDDM. He was unable to undergo exercise stress, has renal impairment & CTCA was contraindicated.
Following pharmacologic stress (Persantin), the scan demonstrated a large reversible perfusion defect in the anterior & anterolateral walls & septum suggestive of severe myocardial ischaemia. LV function was normal. LVEF = 70%.
Subsequently invasive angiophraphy confirmed a sutotal occlusion of the left anterior descending artery which was stented.
Cases 2 & 3
Gated Heart Pool Scan (GHPS)
To evaluate LV Ejection Fraction
50 yr old woman presents with occasional dyspnoea of unknown aetiology. CXR reported an enlarged cardiac silhouette. GHPS showed normal LV systolic function, LVEF = 55%, excluding a cardiomyopathy.
This patient has previous MI. GHPS demonstrated severe left ventricular dialation with an EF of 24%. Referral was made to Carliologist for further management.
Other useful scans in cardiac patients:
Thallium: For myocardial viability
Thyroid: Fr Amiodarone induced thyroiditis