Scintigraphic evaluation of suspected acute myocardial infarction

Ninety-one patients with chest pain suggestive of acute myocardial infarction were studied by static technetium Tc 99m stannous pyrophosphate scintigraphy and dynamic sodium pertechnetate Tc 99m cardioangiography. Twenty-three of 26 patients (88%) with acute transmural infarcts and 12 of 17 patients (71%) with nontransmural infarcts had abnormal static studies. In 45 patients with negative scintigrams, ECG or serum enzyme changes consistent with acute infarction failed to develop. Three false-positive static studies (6%) were recorded. Twenty of 43 (47%) patients with acute infarction had hemodynamic or structural abnormalities identified by cardioangiography. The dynamic study also proved helpful in localizing the site of infarction and in ruling out certain causes of false-positive static scintigrams.