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[Aneurysm-like wall motion abnormality in hibernating myocardium detected by stress thallium scintigraphy]
M Sonoda1, H Tsunenari, T Terashi
1Second Department of Cardiology, National Hospital Kyusyu Cardiovascular Center.
Insights
This case highlights how exercise myocardial scintigraphy can identify hibernating myocardium in patients with severe left ventricular dysfunction, leading to improved cardiac function after revascularization.
Area of Science:
- Cardiology
- Nuclear Cardiology
Background:
- Left ventricular aneurysm and severely impaired wall motion often suggest non-viable myocardium.
- Accurate assessment of myocardial viability is crucial for guiding revascularization therapy.
Observation:
- A 70-year-old female presented with ECG findings suggestive of myocardial infarction and left ventriculography revealed a left ventricular aneurysm with severely abnormal anteroseptal wall motion.
- 201Tl myocardial scintigraphy was employed to assess myocardial viability in the context of suspected non-viable segments.
Findings:
- Percutaneous transluminal coronary angioplasty (PTCA) was performed for severe left anterior descending artery stenosis.
- Follow-up imaging at 3 months demonstrated significant improvement in left ventricular wall motion and near-normal cardiac function.
Implications:
- Exercise myocardial scintigraphy is valuable for diagnosing hibernating myocardium in conditions with severely abnormal wall motion, such as left ventricular aneurysms.
- This diagnostic approach can guide successful revascularization strategies, improving cardiac function and patient outcomes.
Abstract:
A 70-year-old female patient presented and ECG with QS patterns and ST elevation in V1-3. Left ventriculography showed severely abnormal wall motion of the anteroseptal similar to a left ventricular aneurysm. Based on previous experience that 201Tl myocardial scintigraphy revealed possible myocardial viability in a patient with left ventricular aneurysm suspected of having apparently no myocardial viability, percutaneous transluminal coronary angioplasty (PTCA) was performed for severe stenosis of the left anterior descending artery. Follow-up images 3 months later showed a remarkable improvement in parietal motility of the left ventricle and recovery of almost normal cardiac function. This case demonstrates that exercise myocardial scintigraphy is useful for diagnosing hibernating myocardium associated with severely abnormal parietal motility, such as left ventricular aneurysm.