Reverse redistribution of thallium-201 heralding the development of myocardial infarction: description of two cases.
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.
Fragasso
G
G
Division of Cardiology, Istituto Scientifico Ospedale San Raffaele, Milan, Italy.
Chierchia
S L
SL
Pizzetti
G
G
Dosio
F
F
Fazio
F
F
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
D013794:Thallium Radioisotopes