title: Reverse redistribution of thallium-201 heralding the development of myocardial infarction: description of two cases.
abstract: Development of a perfusion defect on the 201Tl image from exercise to redistribution is referred to as reverse redistribution, a finding which has been previously associated with several conditions. We describe here two cases in which the reverse-redistribution phenomenon, observed in a routine stress-redistribution thallium-201 scan performed because of chest pain, was considered to be artifactual. Both patients subsequently developed a myocardial infarction in the areas showing the delayed perfusion defect. The potential clinical significance of the reverse-redistribution phenomenon in these two cases is discussed. When observed in patients with typical anginal pain, the reverse redistribution pattern should be considered a potential marker of tissue at risk in a region with previous, otherwise undetected, subendocardial infarction. In such patients the need for coronary angiography should be carefully considered.
authors.affiliation: Division of Cardiology, Istituto Scientifico Ospedale San Raffaele, Milan, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Fragasso
authors.forename: S L
authors.initials: SL
authors.lastname: Chierchia
authors.forename: G
authors.initials: G
authors.lastname: Pizzetti
authors.forename: F
authors.initials: F
authors.lastname: Dosio
authors.forename: F
authors.initials: F
authors.lastname: Fazio
mesh_terms: D000328:Adult; D005080:Exercise Test; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000503:physiopathology; D011877:Radionuclide Imaging; D013794:Thallium Radioisotopes
chemical_list: D013794:Thallium Radioisotopes