Can nuclear cardiology really help in the emergency departments of the 21st century?
The cardiac troponins are a highly sensitive and specific marker for myocardial damage and have been shown to be useful in the management of patients with acute coronary syndromes. However, some patients with significant ischaemia have no myocardial damage, and therefore negative troponins, despite high risk of subsequent events. Furthermore as a result of the time delay before the troponins can be measured in the peripheral blood, serial sampling is required to rule out myocardial damage. Nuclear perfusion imaging provides an instantaneous assessment of perfusion at the time of injection which is not dependent of on myocardial necrosis, but the presence of flow heterogeneity. Thus these two techniques provide complementary information for the assessment of patients with chest pain and non-diagnostic electrocardiograms, and early perfusion imaging offers the possibility of more rapid assessment and decision making than is possible with troponins.
Swinburn
J
J
Department of Cardiac Research, Northwick Park Hospital, U.K.
Lahiri
A
A
D000208:Acute Disease; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D002309:Cardiology / Q000639:trends*; D003327:Coronary Disease / Q000097:blood / Q000000981:diagnostic imaging / Q000503:physiopathology; D004636:Emergency Service, Hospital / Q000639:trends*; D005544:Forecasting; D006801:Humans; D009683:Nuclear Medicine / Q000639:trends*; D011379:Prognosis; D011877:Radionuclide Imaging
D015415:Biomarkers; D002097:C-Reactive Protein