[Utility of myocardial perfusion scintigraphy in the emergency department for evaluation of patients with chest pain].
OBJECTIVE
To evaluate diagnostic efficacy of rest myocardial perfusion scintigraphy in the detection of acute coronary syndrome in patients with chest pain and non diagnostic electrocardiogram, comparing it with reference techniques, in Emergency Department.


METHODS
Myocardial perfusion scintigraphy was carried out in 40 patients with those defined characteristics in the Emergency Department, administering the radiopharmaceutical in the next 6 hours after the pain was over. All subjects followed routine diagnostic and treatment management. Final diagnosis of coronary disease was established by coronariography and/or stress perfusion myocardial scintigraphy. Patients were followed up for 9-12 months.


RESULTS
Myocardial perfusion scintigraphy showed a negative predictive value of 96,15 % (CI 95 %: 86.84-100.00). The main limitation of its application was breast and diaphragmatic attenuation phenomenon, given that correction algorithms were not available. Global kappa coefficient was 0.78 when to compared interobserver agreement.


CONCLUSIONS
Rest myocardial perfusion scintigraphy is a safe and efficient test in the screening of patients with chest pain suggestive of angor with non-diagnostic ECG in Emergency Department, and also provides prognostic information and risk stratification.
Jiménez-Hoyuela García
J M
JM
Servicio de Medicina Nuclear. Hospital Universitario Virgen de la Victoria, Málaga, España. josem.jimenezhoyuela.sspa@juntadeandalucia.es
Robledo Carmona
J
J
Martínez Del Valle Torres
M D
MD
Ortega Lozano
S
S
Delgado García
A
A
Gómez Doblas
J J
JJ
D000208:Acute Disease; D000789:Angina, Unstable / Q000097:blood / Q000150:complications / Q000000981:diagnostic imaging*; D001281:Atrial Fibrillation / Q000000981:diagnostic imaging; D015415:Biomarkers; D002637:Chest Pain / Q000000981:diagnostic imaging* / Q000209:etiology; D017023:Coronary Angiography; D003430:Cross-Sectional Studies; D003937:Diagnosis, Differential; D004562:Electrocardiography; D004636:Emergency Service, Hospital; D005080:Exercise Test; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging*; D006801:Humans; D006973:Hypertension / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000150:complications / Q000000981:diagnostic imaging*; D011237:Predictive Value of Tests; D019275:Radiopharmaceuticals / Q000627:therapeutic use; D012146:Rest; D017256:Technetium Tc 99m Sestamibi; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods; D014336:Troponin / Q000097:blood
D015415:Biomarkers; D019275:Radiopharmaceuticals; D014336:Troponin; D017256:Technetium Tc 99m Sestamibi