Immunoscintigraphy for detecting acute myocardial infarction without electrocardiographic changes.
OBJECTIVE
To establish whether immunoscintigraphy with antibody to myosin may detect acute myocardial infarction without electrocardiographic changes.


METHODS
Prospective study of patients with suspected acute myocardial infarction or unstable angina with cardiac imaging with 111indium myosin antibody, estimation of cardiac enzyme concentrations, electrocardiography, 201thallium imaging, and radionuclide ventriculography.


METHODS
Coronary care unit in a district general hospital.


METHODS
119 Consecutive patients with suspected acute myocardial infarction or unstable angina. Patients with cardiomyopathy, myocarditis, valvular heart disease, myocardial infarction or cardiac surgery in the previous two weeks or with left bundle branch block and women of childbearing age were excluded.


RESULTS
Of 75 patients with suspected acute myocardial infarction, seven had no diagnostic electrocardiographic changes despite normal conduction patterns. Immunoscintigraphy with myosin antibody disclosed necrosis in all seven patients, which was localised in regions supplied by diseased coronary arteries in all but one. Six patients had abnormal images on 201thallium imaging, and all seven had abnormal wall motion at the site of antibody uptake. One patient with minimal left main stem and right coronary artery atheroma had uptake of antibody at two discrete sites.


CONCLUSIONS
Immunoscintigraphy with antibody to myosin confirms myocardial infarction in the absence of electrocardiographic changes and discloses the site of infarction.
Jain
D
D
Department of Cardiology, Northwick Park Hospital, Harrow.
Lahiri
A
A
Raftery
E B
EB
D000328:Adult; D000368:Aged; D000789:Angina, Unstable / Q000000981:diagnostic imaging; D000911:Antibodies, Monoclonal; D004562:Electrocardiography; D005260:Female; D015637:Gated Blood-Pool Imaging; D006321:Heart / Q000000981:diagnostic imaging*; D006801:Humans; D007205:Indium Radioisotopes; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging*; D009218:Myosins / Q000276:immunology*; D011446:Prospective Studies; D013794:Thallium Radioisotopes
D000911:Antibodies, Monoclonal; D007205:Indium Radioisotopes; D013794:Thallium Radioisotopes; D009218:Myosins