Failure of gated single photon emission computer tomography scan to detect imminent acute plaque rupture causing acute ST-elevation myocardial infarction: case report.
The negative predictive value of a gated single photon emission computer tomography (SPECT) scan is very high, with an event rate of < 1% in the first year. However, the presence of nonobstructive coronary artery plaque should yield normal SPECT scan findings. On the other hand, most plaque ruptures, which are a major cause of acute myocardial infarction, occur in nonobstructive coronary artery plaque. Therefore, the findings of a gated SPECT scan should be normal if a ruptured plaque has not created significant obstruction despite the imminent threat of coronary artery occlusion. We present the first case report of a documented gated SPECT scan in a patient who had experienced an acute anterior Q-wave myocardial infarction showing no significant ischemia in the anterior wall in the last minute of data acquisition.
Movahed
Mohammad-Reza
MR
Nucler Cardiology, University of California, Irvine Medical Center, 101 The City Dr, Bldg 53, Rm 100, Orange, CA 92868-4080, USA. mmovahed@uci.edu
D000208:Acute Disease; D003324:Coronary Artery Disease / Q000150:complications / Q000000981:diagnostic imaging*; D004562:Electrocardiography; D005188:False Negative Reactions; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000209:etiology; D012422:Rupture, Spontaneous; D015899:Tomography, Emission-Computed, Single-Photon