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Abnormal thallium-201 scans in patients with chest pain and angiographically normal coronary arteries

B C Berger, R Abramowitz, C H Park

    The American Journal of Cardiology
    |August 1, 1983
    PubMed

    Insights

    False-positive exercise thallium-201 scans are common in patients with chest pain and normal coronary arteries. Clinical factors do not predict these false-positive results, which often indicate other cardiac issues.

    Area of Science:

    • Cardiology
    • Nuclear Cardiology

    Background:

    • Exercise thallium-201 (TI-201) scans are used to evaluate patients with chest pain.
    • Normal coronary arteries on angiography can be a confounding factor in interpreting these scans.

    Purpose of the Study:

    • To identify clinical factors associated with "false-positive" exercise TI-201 scans in patients with chest pain and normal coronary arteries.
    • To determine the prevalence of other cardiac abnormalities in patients with false-positive TI-201 scans.

    Main Methods:

    • Retrospective review of exercise TI-201 scans and clinical data from 41 patients.
    • Comparison of TI-201 imaging results with clinical factors including sex, beta-blocker therapy, anginal pattern, and exercise electrocardiography.
    • Correlation of abnormal TI-201 scans with subsequent angiography findings and other cardiac conditions.

    Main Results:

    • 11 out of 41 patients (27%) had abnormal exercise TI-201 scans.
    • No specific clinical factor (sex, beta-blocker use, anginal pattern, exercise ECG) predicted false-positive TI-201 scans.
    • Nine of the 11 patients with abnormal scans had other cardiac abnormalities, such as bundle branch block, mitral valve prolapse, or atrial fibrillation.

    Conclusions:

    • False-positive exercise TI-201 scans are frequent in patients with chest pain and normal coronary arteries.
    • Clinical factors are unreliable predictors of false-positive TI-201 results.
    • Abnormal TI-201 scans in this population often point to underlying, non-coronary cardiac conditions.

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