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Does myocardial infarct scintigraphy with 99mTc-PYP accurately detect and quantify infarct size in patients with acute massive transmural infarct?
Does myocardial infarct scintigraphy with 99mTc-PYP accurately detect and quantify infarct size in patients with acute massive transmural infarct?
A single myocardial scintigram with 99mTc-PYP can be grossly inaccurate in detecting and quantifying infarct size, highlighting the need to correlate findings with ECG and cardiac enzymes.
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Single 99mTc-PYP scintigrams may miss massive transmural MI; leaves open reliability of scintigraphy for infarct sizing.
Negative myocardial infarct scintigrams with 99mtechnetium stannous pyrophosphate (99mTc-PYP) were obtained in two patients with acute massive transmural infarct. Both patients died soon after scintigraphy. Because necropsy was performed within hours after death, we were able to correlate the distribution of the tracer within the acutely infarcted tissue with the myocardial scintigram. The clinical implication is that a single myocardial scintigram may be grossly inaccurate in detecting and quantifying infarct size. The scintigraphic findings should always be correlated with the electrocardiographic and enzymatic findings in evaluating patients with possible myocardial infarct.
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Codini et al. (1981) studied this question.
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