title: Thallium-201 myocardial scintigraphic evidence of ischemia in a patient with angina pectoris and normal coronary arteriogram: significance of thallium-201 washout analysis.
abstract: We present a patient who had anginal pain and an abnormal exercise electrocardiogram but a normal coronary arteriogram. We thought that myocardial ischemia was responsible for this symptom in view of the exercise left ventriculogram, exercise thallium-201 myocardial scintigraphy and effect of nitroglycerin on the anginal pain. The left ventriculogram at rest was normal but exercise worsened the entire left ventricular wall motion. Exercise thallium-201 myocardial images showed minimal reduction of radio-activity in the anterior, apical, antero-lateral and postero-lateral wall. Myocardial thallium-201 washout analysis revealed washout abnormalities all over the left ventricular myocardium similar to those of triple vessel disease, supporting the exercise left ventriculographic finding. Myocardial thallium-201 washout analysis as well as the visual method should be performed in patients with angina pectoris and normal coronary arteriograms.
authors.affiliation: Second Department of Internal Medicine, University of Yamaguchi, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Shimizu
authors.forename: M
authors.initials: M
authors.lastname: Ozaki
authors.forename: Y
authors.initials: Y
authors.lastname: Matsuda
authors.forename: R
authors.initials: R
authors.lastname: Kusukawa
mesh_terms: D000328:Adult; D000787:Angina Pectoris / Q000000981:diagnostic imaging*; D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging*; D004562:Electrocardiography; D005080:Exercise Test; D005260:Female; D006801:Humans; D011877:Radionuclide Imaging; D013794:Thallium Radioisotopes
chemical_list: D013794:Thallium Radioisotopes