Case 29
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Case 29
A 53-year-old male with a medical history of type 2 diabetes mellitus, hypertension, hepatitis C infection, end-stage liver disease, and end-stage renal disease, and on chronic hemodialysis is referred for stress testing as a part of a cardiac evaluation prior to consideration for liver and renal transplant.
Adenosine stress/rest Cardiolite imaging was performed. His heart rate increased from 80 to 84 beats/min, and blood pressure changed negligibly from 91/56 to 92/55 mm Hg. He reported no chest pain.
Perfusion imaging showed massive ascites, splenomegaly, and a small shrunken liver. There was no abnormality in myocardial perfusion. Left ventricular wall motion and left ventricular ejection fraction were normal (62% poststress images, 70% rest).
Variable degrees of ascites, splenomegaly, and enlarged or shrunken liver are common incidental findings in patients with end-stage liver disease. Readers should be familiar with the scintigraphic appearance of these abnormalities.
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