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[ST segment elevation during exercise test and perfusion scintigraphy in patients without infarction]

J Candell Riera1, J Castell, A Rius

  • 1Servicio de Cardiología, Hospital General Universitari Vall d'Hebron, Barcelona.

Revista Espanola De Cardiologia
|September 1, 1995
PubMed
Summary

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Exercise-induced ST-segment elevation without prior infarction indicates severe perfusion defects on thallium-201 scintigraphy when the radionuclide is injected during the event. Results align with coronary anatomy when injection precedes the crisis.

Area of Science:

  • Cardiology
  • Nuclear Medicine
  • Diagnostic Imaging

Background:

  • Limited data exists on perfusion scintigraphy for exercise-induced ST-segment elevation without prior infarction.
  • This study evaluates experience with exercise thallium-201 scintigraphy in such patients.

Purpose of the Study:

  • To assess the features of perfusion scintigraphy in patients presenting with exercise-induced ST-segment elevation and no history of infarction.
  • To correlate scintigraphic findings with coronary arteriography results.

Main Methods:

  • Retrospective review of 16,620 exercise thallium-201 scintigraphies performed between 1986 and 1993.
  • Identified 14 patients without previous infarction who exhibited ST-segment elevation during exercise testing.
  • Coronary arteriography was performed in all identified patients.

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Main Results:

  • Patients showed varying degrees of coronary artery disease, from normal to three-vessel disease.
  • ST-segment elevation location varied (inferior, anterior, lateral).
  • Scintigraphy revealed severe perfusion defects when radionuclide injection occurred during ST elevation; findings correlated with coronary anatomy when injection preceded the event.

Conclusions:

  • Exercise-induced ST-segment elevation without prior infarction, especially when radionuclide is injected during the event, indicates severe perfusion defects.
  • Thallium-201 redistribution is incomplete in patients with fixed critical stenoses.
  • Scintigraphy results align with coronary anatomy when radionuclide injection precedes the ST-segment elevation crisis.