title: Pronounced alterations in T-wave morphology during dipyridamole-induced ischaemia.
abstract: The case describes a 77-year-old woman with multivessel coronary disease exhibiting marked changes of T-wave morphology induced by dipyridamole, an unusual finding in which the diagnostic accuracy in this clinical context is uncertain. Gated-SPECT imaging demonstrated severe ischaemia extending through inferior and posterolateral regions of the left ventricle with normal motility and contractile function in response to vasodilator stress. Possible underlying mechanisms and clinical implications of observed electrocardiographic changes are discussed. T-loop modifications during vasodilator stress SPECT and correlation of these changes with the amount of ischaemic injury need further evaluation.
authors.affiliation: Departamento de Cardiología, Centro Cardiovascular Universitario, Hospital de Clínicas, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay; Servicio de Medicina Nuclear, Centro Asistencial del Sindicato Médico, Montevideo, Uruguay. Electronic address: federico.ferrando@gmail.com.
authors.forename: F
authors.initials: F
authors.lastname: Ferrando-Castagnetto
authors.affiliation: Departamento de Cardiología, Centro Cardiovascular Universitario, Hospital de Clínicas, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay.
authors.forename: R
authors.initials: R
authors.lastname: Ricca-Mallada
authors.affiliation: Servicio de Medicina Nuclear, Centro Asistencial del Sindicato Médico, Montevideo, Uruguay.
authors.forename: R
authors.initials: R
authors.lastname: Ferrando-Castagnetto
mesh_terms: D000368:Aged; D000787:Angina Pectoris / Q000000981:diagnostic imaging; D055426:Cardiac-Gated Single-Photon Emission Computer-Assisted Tomography; D004176:Dipyridamole / Q000494:pharmacology*; D004280:Dobutamine / Q000494:pharmacology; D025401:Echocardiography, Stress; D004562:Electrocardiography; D005080:Exercise Test; D005260:Female; D006329:Heart Conduction System / Q000187:drug effects / Q000503:physiopathology*; D006439:Hemodynamics; D006801:Humans; D017202:Myocardial Ischemia / Q000139:chemically induced / Q000503:physiopathology*; D055414:Myocardial Perfusion Imaging; D019275:Radiopharmaceuticals / Q000032:analysis; D000072657:ST Elevation Myocardial Infarction / Q000503:physiopathology; D017256:Technetium Tc 99m Sestamibi / Q000032:analysis; D014665:Vasodilator Agents / Q000494:pharmacology*
chemical_list: D019275:Radiopharmaceuticals; D014665:Vasodilator Agents; D004280:Dobutamine; D004176:Dipyridamole; D017256:Technetium Tc 99m Sestamibi
keywords: (99m)Tc-MIBI SPECT; Bucle; Dipiridamol; Dipyridamole; Ischaemia; Isquemia; Loop; Onda T; T-wave