Published on 02/03/2015 by admin
Filed under Internal Medicine
Last modified 02/03/2015
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Case 3
A 60-year-old woman was referred for SPECT MPI for evaluation of chest pain. The chest pain description was consistent with atypical angina. Her coronary risk factors included hyperlipidemia, hypertension, and a family history of premature coronary artery disease (CAD).
Resting ECG was normal.
According to published appropriateness criteria, stress MPI would be appropriate (median score = 7) in a patient with chest pain, an interpretable ECG, and an intermediate pretest probability of CAD based on presenting symptoms, age, and gender.
She exercised to a maximal workload of 10 METs, achieving a peak heart rate of 150 beats/min (94% of maximum age-predicted heart rate). No chest pain was reported during exercise, and the blood pressure and ECG responses were normal.
SPECT MPI demonstrated normal uniform uptake of 99mTc-sestamibi in all myocardial regions. Gated SPECT demonstrated normal myocardial systolic thickening in all myocardial regions, with a computed left ventricular ejection fraction (LVEF) of 63%.
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