Nuclear Cardiology Around the World: A PatientFirst Approach

Case 2 Slides

Pdf Summary

Prof. Fabien Hyafil presented a case involving a 72-year-old man with cardiovascular risk factors who underwent a myocardial perfusion scintigraphy due to complaints of shortness of breath during intense physical activity. The patient had a positive stress ECG and high blood pressure during a stress test, which led to a SPECT-MPS revealing small reversible perfusion defects and LV dilatation post-stress, indicating balanced myocardial ischemia. Subsequent coronary CTA confirmed three-vessel CAD with significant stenoses in the LAD, LCx, LM, and RCA. This was followed by an invasive coronary angiography showing high-grade stenoses in the LAD and LCx, with stent implantation performed. A follow-up exercise SPECT-MPS six months later showed negative results. The case highlights the utility of exercise SPECT-MPS in evaluating symptoms during stress and confirming myocardial ischemia, the role of coronary CTA in risk stratification by identifying high-grade stenoses, and the complementary nature of functional and anatomical imaging in assessing patients with chronic CAD.

Keywords

Prof. Fabien Hyafil

case presentation

myocardial perfusion scintigraphy

cardiovascular risk factors

SPECT-MPS

coronary CTA

LV dilatation

myocardial ischemia

coronary artery disease

exercise stress test