title: False-positive defects on exercise 99mTc-sestamibi SPECT imaging, but not on dipyridamole 99mTc-sestamibi SPECT imaging, in a patient with right bundle branch block (RBBB).
abstract: False-positive findings with myocardial perfusion imaging (MPI) have frequently been identified in the presence of left bundle branch block (LBBB) and tend to lower the accuracy of MPI in individuals with normal coronary angiographs. Pharmacologic stress is recognized as the preferred method for MPI in patients with LBBB. In contrast, very few studies have evaluated the effect of right bundle branch block (RBBB) on MPI, and there is no consensus regarding the selection of pharmacologic versus exercise stress during MPI for the RBBB patient. In this study, we present a 45-year-old man with RBBB, who has a normal coronary artery angiography, but who showed abnormal myocardial perfusion with exercise MPI, and normal perfusion on dipyridamole MPI. The aim of the study is to stimulate awareness that the stress method selected for patients with RBBB can potentially interfere with the accuracy of the data.
authors.affiliation: Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran.
authors.forename: Hamid
authors.initials: H
authors.lastname: Javadi
authors.forename: Sara
authors.initials: S
authors.lastname: Jallalat
authors.forename: Shahriar
authors.initials: S
authors.lastname: Semnani
authors.forename: Mehdi
authors.initials: M
authors.lastname: Mogharrabi
authors.forename: Iraj
authors.initials: I
authors.lastname: Nabipour
authors.forename: Moloud
authors.initials: M
authors.lastname: Abbaszadeh
authors.forename: Majid
authors.initials: M
authors.lastname: Assadi
mesh_terms: D002037:Bundle-Branch Block / Q000000981:diagnostic imaging* / Q000503:physiopathology; D004176:Dipyridamole / Q000494:pharmacology*; D015444:Exercise; D005189:False Positive Reactions; D006801:Humans; D008297:Male; D008875:Middle Aged; D013312:Stress, Physiological / Q000187:drug effects; D017256:Technetium Tc 99m Sestamibi; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*
chemical_list: D004176:Dipyridamole; D017256:Technetium Tc 99m Sestamibi