Stress MIBI scintigraphy in multiple coronary-pulmonary fistula: failure to demonstrate "steal" phenomenon.
Stress radionuclide studies were performed in a patient with angiographically proven multiple coronary-pulmonary fistulas, in the presence of atypical chest pain. MIBI scintigraphy showed no myocardial perfusion defects. Multigated ventriculography showed an ejection fraction of 68% and 80% at rest and following exercise, respectively. Three separate fistulas were present between each coronary artery and the pulmonary trunk. The Qp:Qs ratio was 1.3. In the presence of atypical chest pain, stress MIBI scintigraphy and multigated ventriculography both failed to reveal myocardial ischemia in a 49-year-old patient with multiple coronary-pulmonary fistulas. She is using no medication, but advice concerning endocarditis prophylaxis was given.
Said
S A
SA
Department of Cardiology, Streekziekenhuis Midden-Twente, Hengelo, Netherlands.
Bucx
J J
JJ
van de Weel
F A
FA
D001159:Arterio-Arterial Fistula / Q000000981:diagnostic imaging*; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009570:Nitriles / Q000627:therapeutic use*; D015609:Organotechnetium Compounds / Q000627:therapeutic use*; D011651:Pulmonary Artery / Q000000981:diagnostic imaging*; D015635:Radionuclide Ventriculography; D017256:Technetium Tc 99m Sestamibi
D009570:Nitriles; D015609:Organotechnetium Compounds; D017256:Technetium Tc 99m Sestamibi