Published on 02/03/2015 by admin
Filed under Internal Medicine
Last modified 03/03/2015
This article have been viewed 956 times
Case 14
A 62-year-old man with a history of left bundle branch block (LBBB) diagnosed 25 years earlier is now referred for cardiology consultation because of an abnormal gated SPECT MPI at an outside facility. By report, there are fixed inferior and septal defects suggestive of infarction, as well as severe LV systolic dysfunction (LVEF = 14%).
He has no cardiac symptoms despite vigorous physical activity. He has no coronary artery disease (CAD) risk factors. His mother had an “enlarged heart.”
The baseline ECG demonstrates normal sinus rhythm, left-axis deviation, and LBBB.
Following are options for identification of cardiomyopathy due to CAD (ischemic cardiomyopathy):
The patient preferred to avoid invasive coronary angiography. After discussion of the available options, he elected to undergo coronary CT angiography.
The left ventricular cavity volumes were markedly elevated, and left ventricular systolic function was severely reduced, with a computed LVEF of 18%. Severe global hypokinesis was observed, consistent with ischemic or nonischemic cardiomyopathy.
Clinical Nuclear Cardiology State of the Art and Future Directio
WhatsApp us
