Published on 02/03/2015 by admin
Filed under Internal Medicine
Last modified 03/03/2015
This article have been viewed 903 times
Case 13
A 74-year-old man with hypertension and diabetes was referred for preoperative assessment prior to bladder surgery. He reports a “normal” stress test 14 years ago.
He describes severely reduced functional capacity (<4 METs), but he denies angina. Dipyridamole PET MPI was requested for preoperative risk assessment.
The baseline ECG demonstrates normal sinus rhythm, right bundle branch block, and left anterior fascicular block.
The peak stress PET images demonstrate a mild defect in the apical region. Mild defect reversibility is evident on resting images, suggestive of ischemia. Also note that the left ventricular cavity is much larger on peak stress images compared to resting images, with a computed stress/rest left ventricular cavity ratio (SRLVCR) of 1.39.
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