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Constrictive pericarditis causing a positive TI-201 SPECT stress test for myocardial ischemia
R J Matthews1, J Lightfoote, R S Grusd
1Diagnostic Imaging of Southern California Medical Group, Sherman Oaks.
Clinical Nuclear Medicine
|August 1, 1990
Insights
Constrictive pericarditis can cause myocardial ischemia, detectable with thallium SPECT stress testing. Surgical treatment (pericardiectomy) resolved the ischemia, normalizing test results.
Area of Science:
- Cardiology
- Nuclear Cardiology
- Cardiac Surgery
Background:
- Constrictive pericarditis is a condition involving inflammation and thickening of the pericardium.
- Myocardial ischemia refers to reduced blood flow to the heart muscle.
- Thallium-201 single-photon emission computed tomography (SPECT) stress testing is a diagnostic tool for assessing myocardial perfusion.
Observation:
- A patient presented with constrictive pericarditis.
- Initial thallium SPECT stress testing indicated myocardial ischemia.
- Following pericardiectomy, repeat thallium SPECT stress testing showed normal results.
Findings:
- The positive thallium SPECT stress test results for myocardial ischemia resolved after pericardiectomy.
- The resolution of ischemia suggests a direct link between constrictive pericarditis and reduced myocardial blood flow.
Implications:
- Constrictive pericarditis should be considered as a potential cause of myocardial ischemia.
- Thallium SPECT stress testing is a valuable method for demonstrating ischemia in constrictive pericarditis.
- Surgical intervention can effectively reverse ischemia caused by constrictive pericarditis.
Abstract:
A case of constritive pericarditis was demonstrated by a positive thallium SPECT stress test for myocardial ischemia. After pericardiectomy, the repeat thallium stress test was normal. The disappearance of the criteria for a positive test suggests that constrictive pericarditis can cause myocardial ischemia, which can be demonstrated by thallium SPECT stress testing.