Nuclear cardiology techniques in the assessment of ischemic heart disease

Invasive techniques of cardiac catheterization and angiography have become the gold standard for the diagnosis and management of patients with ischemic heart disease. More recently there has been a remarkable development of noninvasive imaging techniques which has resulted in improved ability to select patients in need of invasive investigations and in a more complete understanding of the physiological and clinical significance of information obtained from such invasive investigations. The value and limitations of the 3 most common techniques, radionuclide ventriculography, myocardial perfusion scintigraphy and acute myocardial infarction scintigraphy, are discussed in this review in relation to the assessment of patients with proven or suspected ischemic heart disease. These nuclear cardiology techniques are now available in most hospitals with nuclear medicine equipment; a good understanding of the strengths and weaknesses of each technique is essential for optimal clinical use.