Thallium-201 myocardial scintigraphic evidence of ischemia in a patient with angina pectoris and normal coronary arteriogram: significance of thallium-201 washout analysis.
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.
Shimizu
T
T
Second Department of Internal Medicine, University of Yamaguchi, Japan.
Ozaki
M
M
Matsuda
Y
Y
Kusukawa
R
R
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
D013794:Thallium Radioisotopes