[Myocardial perfusion SPECT with 99mTc-tetrofosmin and thoracic SPECT with Gallium-67 SPECT in a patient with chest pain and a history of sarcoidosis].
We present the case of a 54-year-old male patient, with history of diagnosed sarcoidosis some years ago and myocardial involvement, who being asymptomatic, shows chest pain because of which he goes to the emergency room of the hospital. During the first hours of his admission the pain relieves with nonsteroidal antiinflammatory medication, an electrocardiogram demonstrates changes of early repolarisation with pericardial involvement, the enzymes don't rise and the echocardiogram reveals a slight pericardial effusion. The differential diagnosis is between a chest pain due to ischemia, and the secondary to myopericarditis in the clinical context of a sarcoidosis. Myocardial perfusion rest SPECT is required which is compatible with lateral acute myocardial infarction (AMI) with extension to inferior wall. A coronary angiography was carried out and showed two vessels disease (RCA and Cx), PTCA and stent were carried out successfully. During the admission a thoracic scintigraphy and SPECT with gallium -67 showed an uptake in lateral wall of left ventricle (LV). Nothing about active sarcoidosis was found.
Servicio de Medicina Nuclear, Hospital General de Ciudad Real, Ciudad Real. srodado@sescam.jccm.es
S
S
Rodado Marina
V M
VM
Poblete García
A M
AM
García Vicente
S
S
Ruiz Solís
M P
MP
Talavera Rubio
M
M
Cortés Romera
A
A
Soriano Castrejón
D015906:Angioplasty, Balloon, Coronary; D002637:Chest Pain / Q000209:etiology*; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy; D052279:Creatine Kinase, MB Form / Q000097:blood; D003937:Diagnosis, Differential; D004562:Electrocardiography; D005710:Gallium Radioisotopes; D006321:Heart / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000150:complications / Q000000981:diagnostic imaging* / Q000628:therapy; D009205:Myocarditis / Q000000981:diagnostic imaging; D009943:Organophosphorus Compounds; D015609:Organotechnetium Compounds; D010490:Pericardial Effusion / Q000000981:diagnostic imaging / Q000209:etiology; D010493:Pericarditis / Q000000981:diagnostic imaging; D019275:Radiopharmaceuticals; D012507:Sarcoidosis / Q000150:complications / Q000000981:diagnostic imaging*; D015607:Stents; D015899:Tomography, Emission-Computed, Single-Photon; D014463:Ultrasonography
D005710:Gallium Radioisotopes; D009943:Organophosphorus Compounds; D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; C078700:technetium tc-99m tetrofosmin; D052279:Creatine Kinase, MB Form