6' 5" Male with Right Coronary Artery Ischemia

 

All images on this web page are displayed at default contrast settings.
No contrast enhancement or “background subtraction” has been performed.

History:  55 y/o man with family history of father with CABG at ~55 y/o. Cholesterol = 240.
Complaints of exertional sub-sternal chest pain and shortness of breath.

Height:   6' 5”

Weight:   235 pounds.

Stress ECG:   Rest:  Normal.   Peak stress:  1.5 mm horizontal to upsloping ST depression in inferior leads;  1.5 - 2.0 mm horizontal ST segment depression.

Tracer dose:   31.2 mCi at peak treadmill stress

Timing:   Tracer was injected at peak treadmill exercise. After a 57 minute delay, SPECT images were obtained on the standard-type, dual-detector system. Approximately one hour after this, images were obtained on the CardiArc® scanner. No additional tracer was administered between the two scans.

Acquisition Duration
Dual-detector w
LEHR collimation		 10.6 min
CardiArc® 4.7 min

Scan findings (stress images):

Dual-detector system with high-resolution collimation (LEHR):  Large sized inferobasal defect. Small apical defect.
CardiArc®: Large defect involving the inferobasal, inferior, posterolateral and inferolateral walls and the apex.

Catheterization findings:   Isolated, high-grade, proximal stenosis of the PDA (posterior descending artery).

p8821 stress short-axis Standard System
Dual-detector LEHR - 10.6 min acquisition

CardiArc stress short-axis
CardiArc® - 4.7 min acquisition


Dual-detector stress VLA
Dual-detector LEHR - 10.6 min acquisition

CardiArc stress VLA
CardiArc® - 4.7 min acquisition


Dual-detector stress HLA
Dual-detector LEHR - 10.6 min acquisition

CardiArc stress HLA
CardiArc® - 4.7 min acquisition

Discussion:   The proximal nature of the stenosis and the extensive ECG findings are more consistent with the CardiArc® images. The higher lesion contrast of CardiArc® may make it easier to define the full extent of perfusion abnormalities.