Key result
Dual SPECT imaging with Tc-99m pyrophosphate and Tl-201 successfully depicted circumferential subendocardial infarction in a patient with aortic stenosis but no coronary artery stenosis.
Case Report (n=1)
Dual SPECT imaging with Tc-99m pyrophosphate and Tl-201 can effectively visualize circumferential subendocardial myocardial infarction in patients with aortic stenosis and normal coronary arteries.
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Should not yet alter practice in aortic stenosis; hypothesis-generating for dual SPECT in subendocardial infarction without CAD.
An 88-year-old woman with aortic stenosis, who had demonstrated fever for several preceding days, complained of angina and orthopnea. Although the symptoms were suggestive of acute myocardial infarction, coronary angiography failed to demonstrate coronary artery stenosis. Dual SPECT with Tc-99m pyrophosphate and Tl-201 demonstrated an abnormal accumulation of the former tracer throughout the inner layers of the left ventricle, indicating circumferential subendocardial infarction. Confirmation of this diagnosis is often difficult, and there have been only a few documented cases. However, the present images clearly depicted this unusual view of infarction in a patient with aortic stenosis but without coronary artery stenosis.
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Yamano et al. (2008) conducted a case report in Aortic stenosis with suspected acute myocardial infarction (n=1). Dual SPECT imaging with Tc-99m pyrophosphate and Tl-201 was evaluated on Detection of circumferential subendocardial myocardial infarction. Dual SPECT imaging with Tc-99m pyrophosphate and Tl-201 successfully depicted circumferential subendocardial infarction in a patient with aortic stenosis but no coronary artery stenosis.
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