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Perfusion stress test (with 99mTc labelled sestamibi [15]) is appropriate for select patients, especially those with an abnormal resting electrocardiogram. Intracoronary ultrasound or angiogram can provide more information but is invasive and carries the risk of complications associated with cardiac catheterization procedures.
Myocardial perfusion imaging or scanning (also referred to as MPI or MPS) is a nuclear medicine procedure that illustrates the function of the heart muscle (). [1]It evaluates many heart conditions, such as coronary artery disease (CAD), [2] hypertrophic cardiomyopathy and heart wall motion abnormalities.
Cardiac stress testing is used to determine to assess cardiac function and to disclose evidence of exertion-related cardiac hypoxia. Radionuclide testing using thallium or technetium can be used to demonstrate areas of perfusion abnormalities. With a maximal stress test the level of exercise is increased until the person's heart rate will not ...
The radioisotope thallium-201 (as the soluble chloride TlCl) is used in small amounts as an agent in a nuclear medicine scan, during one type of nuclear cardiac stress test. Soluble thallium salts (many of which are nearly tasteless) are highly toxic and they were historically used in rat poisons and insecticides. Because of their nonselective ...
In the second set, the patient is stressed either by exercising on a treadmill or pharmacologically. The drug is injected at peak stress and then imaging is performed. The resulting two sets of images are compared with each other to distinguish ischemic from infarcted areas of the myocardium. This imaging technique has a sensitivity of around ...
Nuclear medicine myocardial perfusion scan with thallium-201 for the rest images (bottom rows) and Tc-Sestamibi for the stress images (top rows). The nuclear medicine myocardial perfusion scan plays a pivotal role in the non-invasive evaluation of coronary artery disease. The study not only identifies patients with coronary artery disease; it ...
The underlying principle is, under conditions of stress, diseased myocardium receives less blood flow than normal myocardium. MPI is one of several types of cardiac stress test . As a nuclear stress test , the average radiation exposure is 9.4 mSv, which when compared with a typical 2 view chest X-ray (.1 mSv) is equivalent to 94 Chest X-rays.
In stable patients whose symptoms have resolved by the time of evaluation, Technetium (99mTc) sestamibi (i.e. a "MIBI scan"), thallium-201 chloride or Rubidium-82 Chloride can be used in nuclear medicine to visualize areas of reduced blood flow in conjunction with physiologic or pharmacologic stress. [3] [4] Thallium may also be used to ...