False-negative myocardial scintigraphy in balanced three-vessel disease, revealed by coronary pressure measurement.
In nuclear perfusion imaging of the myocardium, a false-negative test result in patients with balanced three-vessel disease is a well-known pitfall. This paper describes a patient with typical chest pain and a negative myocardial perfusion scintigram. At coronary angiography, intermediate stenoses in the left anterior descending (LAD), left circumflex (LCX), and right coronary (RCA) arteries were present. Fractional flow reserve, measured by coronary pressure measurement, was 0.54, 0.56, and 0.66 respectively for the LAD, LCX, and RCA, unequivocally demonstrating the presence of balanced three-vessel disease. The patient underwent successful bypass surgery and remained event-free thereafter.
Department of Cardiology, Catharina Hospital, Eindhoven, The Netherlands.
Wilbert H
WH
Aarnoudse
Kees-Joost B M
KJ
Botman
Nico H J
NH
Pijls
D000328:Adult; D002637:Chest Pain / Q000209:etiology; D001026:Coronary Artery Bypass; D003326:Coronary Circulation; D003327:Coronary Disease / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D003937:Diagnosis, Differential; D005188:False Negative Reactions; D006801:Humans; D008297:Male; D009943:Organophosphorus Compounds; D015609:Organotechnetium Compounds; D011237:Predictive Value of Tests; D011877:Radionuclide Imaging / Q000592:standards*
D009943:Organophosphorus Compounds; D015609:Organotechnetium Compounds; C078700:technetium tc-99m tetrofosmin