title: Stress thallium-201 myocardial scintigraphy in patients with complete occlusion of the left main coronary artery.
abstract: Complete occlusion (CO) of the left main coronary artery (LMCA) is a rare but often fatal condition. The diagnosis is frequently missed because the signs and symptoms are often obscure and diverse. We describe three patients with CO-LMCA who showed unusual myocardial scintigraphic findings. The patients had extensive right-to-left collateral channels and decreased uptake and washout rates at the basal anterior and anterolateral portions of the heart wall during stress thallium-201 scintigraphy. The basal anterior to anterolateral portion of the heart wall is the most distant from the collateral artery and should be the most ischemic area shown during exercise, resulting in this scintigraphic pattern. This scintigraphic finding may be useful for the noninvasive diagnosis of CO-LMCA.
authors.affiliation: Second Department of Internal Medicine, Gunma University School of Medicine, Gunma, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Hatori
authors.forename: T
authors.initials: T
authors.lastname: Toyama
authors.forename: T
authors.initials: T
authors.lastname: Yokoyama
authors.forename: M
authors.initials: M
authors.lastname: Arai
authors.forename: M
authors.initials: M
authors.lastname: Kurabayashi
authors.forename: T
authors.initials: T
authors.lastname: Kanda
authors.forename: S
authors.initials: S
authors.lastname: Oshima
mesh_terms: D000368:Aged; D003097:Collateral Circulation / Q000502:physiology; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging*; D012680:Sensitivity and Specificity; D013794:Thallium Radioisotopes; D015899:Tomography, Emission-Computed, Single-Photon
chemical_list: D013794:Thallium Radioisotopes