Clinical History

This is a 68-year-old female with diabetes and a positive family history for coronary artery disease. Today's examinations is performed to evaluate myocardial perfusion and rule out reversible areas of ischemia.

Technique

The patient underwent a two day protocol myocardial perfusion scan. At rest on the first day, the patient was injected with 8.4 millicuries of 99m Tc Cardiolite at 1:00p.m. One hour later SPECT imaging was performed. At a later date, the patient underwent the stress portion of the examination using dobutamine as a stress agent. At the point of peak stress, 23 millicuries of 99m Tc Cardiolite were injected at 12 p.m. Thirty five minutes later, SPECT imaging of the heart was obtained. Acquisition was made by standard methods and no significant degree of patient motion was identified.

Findings

There is a moderate sized reperfusion defect involving most of the inferior wass with extension towards the base. There is also reversibility identified in the region of the apex. At the basal most segment of the inferior wall there appears to be a component of a fixed perfusion defect and the presence of a pervious infarction in this region cannot be ruled out. No other areas of reversible ischemia are identified.

Impressions

Stress/Rest Myocardial Perfusion Imaging Demonstrating:

1. Moderate sized area of reversible ischemia in the inferior and inferobasal myocardium.

2. Component of a fixed defent involving the most basal portion of the inferior wall.

3. Reversible ischemia at the apex.

Comments

none