Overweight, hypertension, high cholesterol, stress.
Typical chest pain.
Echocardiogram: mild LVH, normal LV function.
Exercise test: chest pain witn no ECG changes.
Myocardial perfusion study (MPS) with exerecise.
Teaching points:
In patients with no known coronary artery disease and at overall low-tointermediate risk, myocardial perfusion SPECT adds prognostic information and risk-stratifies patients beyond clinical and exercise data.
Semiquantitative information obtained by gated SPECT provides important measurements of disease extent and severity.
Perfusion scores are useful tools in clinical decision making and have been shown to have independent risk-stratification value.
Post-ischemic stunning, as assessed by gated SPECT, is a marker for poor prognosis, particularly for ischemic cardiac events.
Patients with high risk results should be managed aggressively - with revascularization procedures if possible.
