Importance of wall motion analysis in the diagnosis of left main disease using stress nuclear myocardial perfusion imaging.
We describe a case of a 54-year-old male who underwent exercise technetium-99m sestamibi myocardial perfusion imaging prior to his renal transplantation. With exercise, the patient's myocardial perfusion imaging did not show any transient or fixed myocardial perfusion abnormalities due to balanced ischemia. However, wall motion analysis showed a new global left ventricular systolic dysfunction on post-exercise images. Coronary angiography showed severe left main coronary lesion involving ostia of left anterior descending, ramus intermedius and left circumflex coronary arteries with moderate right coronary artery disease. If one had used the perfusion imaging alone in this patient, the severe multivessel disease including left main coronary disease could have been missed. In this article we emphasize the importance of wall motion analysis in patients undergoing myocardial perfusion imaging.
Kumar
Shekar P
SP
Section of Cardiology, Department of Internal Medicine, East Carolina University Brody School of Medicine, Greenville, NC 27858-4354, USA.
Movahed
Asssad
A
D001794:Blood Pressure / Q000502:physiology; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000503:physiopathology*; D003331:Coronary Vessels / Q000503:physiopathology; D004562:Electrocardiography; D005080:Exercise Test; D006801:Humans; D008297:Male; D008875:Middle Aged; D015425:Myocardial Reperfusion; D019275:Radiopharmaceuticals; D012720:Severity of Illness Index; D013599:Systole / Q000502:physiology; D017256:Technetium Tc 99m Sestamibi; D015899:Tomography, Emission-Computed, Single-Photon; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000503:physiopathology
D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi