[Considerations on myocardial scintigraphy with 201thallium after stress]

An heterogeneous group of 12 patients has been studied with 201thallium myocardial scintigraphy after stress (MSS); has been used an electronic calculator which made it possible to increase the reliability of the method. Eight patients were males, 4 females; the average age were 52.6 years. The 201thallium (1.7-2 mCi) is injected (through a Teflon cannula inserted in the forearm) 1' before the interruption of the stress test on the cycloergometer. After 10' tests are made in AP-LAO and LL view; a second test is carried out after an hour, and, if necessary, after 4-6 hours time. The results are interpreted as: a) positive: absence (++) or obvious defect in perfusion (+); b) negative: normal perfusion (-); c) questionable: activity not significantly reduced (+/-). In some cases, the authors studied correlations and discordances between MSS and clinical, coronarographic and echocardiographic data. It has been considered moreover, the uptake's and release's variations of the radio-isotope in relation with experimental knowledge of myocardial extraction and clearance. We conclude by emphasizing the interest of this method and suggesting some practical considerations: 1) Patients with negative MSS don't need coronarography. 2) Positive MSS, but restricted deficit, good delayed reperfusion, good clinical pharmacological control would permit a delay of coronarography. 3) Clear multiple deficit need coronarography. 4) Usefulness of the MSS for long-term control of the evolution of coronary disease and of patients operated of aortocoronary bypass.