Single-Photon Emission Computed Tomography/Myocardial Perfusion Imaging

SPECT perfusion scintigraphy is an important test in the assessment for myocardial ischemia.

In patients with active chest pain, an ECG with no ischemic changes, and an initial negative troponin, rest SPECT has been demonstrated to be the test of choice .
It has been shown to be less sensitive than stress SPECT imaging, however, if performed after the chest pain has subsided.

The commonly used radionuclide agents are TI-201 (Thallium) chloride and (Technetium) Tc-99m-labeled agents (e.g., sestamibi, tetrofosmin). .
The absence of a perfusion defect on an acute rest study is associated with a very high negative predictive value for ACS ( Acute coronary syndrome )evaluation.

A perfusion defect that becomes apparent or becomes larger during exercise stress or pharmacologic stress defines ischemic myocardium.

ECHO – to follow.