HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Lowenthal, I. S. Articles by Clemson, H. C. Search for Related Content PubMed PubMed Citation Articles by Lowenthal, I. S. Articles by Clemson, H. C.

Diagnosis of Acute Myocardial Infarction in Patients Undergoing Open Heart Surgery: A Comparison of Serial Myocardial Imaging with Cardiac Enzymes, Electrocardiography, and Vectorcardiography

Veterans Administration Hospital, West Roxbury, Massachusetts
Peter Bent Brigham Hospital and Harvard Medical School, Boston, Massachusetts
Lynn Hospital, Lynn, Massachusetts

Correspondence: For reprints contact: Donald E. Tow, Nuclear Medicine Service, Veterans Administration Hospital, 1400 V.F.W. Parkway, West Roxbury, MA 02132.

ABSTRACT

In 44 consecutive patients undergoing elective open heart surgery (OHS), serial electrocardiograms (ECG), vectorcardiograms (VCG), serum CPK, cardiac isoenzymes (CPKMB), and myocardial images using Tc-99m pyrophosphate were obtained, before and after the operation, for the detection of acute myocardial infarction (AMI). Twenty-nine patients developed one or more positive tests postoperatively. Two patients had positive myocardial scintiscans; both had other evidence of infarction. Conversely, the appearance of CPKMB, or new ECG and VCG changes, occurred frequently without evidence of infarction, and were not associated with the development of a positive scintiscan. The results show that false-negative results are infrequent in patients imaged early after OHS, and that cardiac surgical procedures do not cause a high incidence of false-positive scintigrams. Consequently, radionuclide imaging for AMI offers an important adjunct for excluding acute infarction following open heart surgery.