Published on 02/03/2015 by admin
Filed under Internal Medicine
Last modified 03/03/2015
This article have been viewed 933 times
Case 12
A 65-year-old woman presents with recent onset of nonexertional chest pain. She has no coronary disease risk factors. She is referred for SPECT MPI.
She exercised on a Bruce protocol to a maximal workload of 10 METs. Peak heart rate was 155 beats/min (100% of maximal age-predicted heart rate). No exercise-induced symptoms were reported, and the blood pressure and ECG responses were normal.
The rotating raw planar images demonstrate a prominent shadow produced by the right breast, but no left breast shadow is present. This patient has a history of breast cancer, and her prior treatment included left mastectomy. Mild patient motion is also present, and moderate GI tracer interference is evident on resting images.
The poststress SPECT images demonstrate a mild defect in the inferior and inferolateral regions. Minimal defect reversibility is evident on resting images, suggestive of ischemia (but possibly the result of GI tracer interference). The perfusion pattern (highest tracer activity in the anterior and anterolateral regions, with relatively reduced activity in the inferior region) is a typical pattern in men. However, this perfusion pattern is not typical for a normal woman.
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