Cardioversion can induce skeletal muscle necrosis leading to false-positive In-111 antimyosin imaging for myocardial infarction.
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Clinicians should consider recent cardioversion when interpreting In-111 antimyosin scans; this case leaves open the prevalence of such false-positives.
In-111 antimyosin imaging was performed to identify a recent myocardial infarction in a 46-year-old man who was resuscitated after cardiac massage and cardioversion. Six days after admission, planar anterior and left anterior oblique views (at 45- and 70-degree angles) and SPECT were performed 48 hours after injection of In-111 antimyosin. Uptake was observed in the anterior thoracic wall and the left flank. This uptake could be explained by muscle necrosis induced by the electroshock. Similar cases have been reported with Tc-99m pyrophosphate.
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Alberini et al. (1999) studied this question.
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