Journal of the Practice of Cardiovascular Sciences

CURRICULUM IN CARDIOLOGY - IMAGES
Year
: 2016  |  Volume : 2  |  Issue : 3  |  Page : 192--193

Nuclear cardiology quiz


Shambo Guha Roy, Girish Kumar Parida, Chetan D Patel 
 Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India

Correspondence Address:
Chetan D Patel
Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi - 110 029
India




How to cite this article:
Roy SG, Parida GK, Patel CD. Nuclear cardiology quiz.J Pract Cardiovasc Sci 2016;2:192-193


How to cite this URL:
Roy SG, Parida GK, Patel CD. Nuclear cardiology quiz. J Pract Cardiovasc Sci [serial online] 2016 [cited 2021 Dec 7 ];2:192-193
Available from: https://www.j-pcs.org/text.asp?2016/2/3/192/201379


Full Text

 Question



A 66-year-old diabetic, hyperlipidemic female presented with heart failure. Her coronary angiography revealed triple vessel disease. Coronary artery bypass grafting was planned for the patient. On presurgery, she was referred to nuclear cardiology laboratory for evaluation.

What scans she underwent? What are the findings?

 View Answer

 Answer



The patient underwent resting N-13 NH3 perfusion and F-18 fludeoxyglucose (FDG) metabolic study for myocardial viability assessment The adjacent rows show N-13 NH3 perfusion and F-18 FDG metabolic study, respectively. The rows 1–4 are short axis images; 5 and 6 are vertical long axis; and 7 and 8 are horizontal long axis images [Figure 1].{Figure 1}

Perfusion images show large, hypoperfused area in the anteroseptal wall and apex [white arrows in [Figure 2]. Metabolic images show preserved FDG uptake in the corresponding areas [Figure 2]. This “perfusion and metabolic mismatch” defect in the anteroseptal wall and apex is consistent with hibernating myocardium.[1]{Figure 2}

The polar map shows perfusion defect (blacked out area in the N-13 NH3 study) involving the anteroseptal wall and apex, which shows mismatch with FDG images [white area, [Figure 3]]. Software quantification shows 26% left ventricular myocardium is hibernating.[2] Then, the patient underwent coronary artery bypass surgery as revascularization improves the function of hibernating myocardium.[1]{Figure 3}

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

1Camici PG, Prasad SK, Rimoldi OE. Stunning, hibernation, and assessment of myocardial viability. Circulation 2008;117:103-14.
2Partington SL, Kwong RY, Dorbala S. Multimodality imaging in the assessment of myocardial viability. Heart Fail Rev 2011;16:381-95.