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Reversible Thallium-201 Perfusion Defects of the Septal and Inferoapical Segments in a Patient with Incomplete Right Bundle Branch Block and Normal Coronary Angiogram

University of Kentucky and Department of Veterans Affairs Medical Centers, Lexington, Kentucky

Correspondence: For reprints contact: Dr. Wei-Jen Shih, Nuclear Medicine Service, Department of Veterans Affairs Medical Centers, Lexington, KY 40511.

ABSTRACT

Possible causes of reversible perfusion defect in exercise-rest ²⁰¹Tl myocardial images in a patient with a normal coronary artery angiogram include left bundle branch block, coronary spasm, myocardial bridges, hypertrophic cardiomyopathy, mitral valve prolapse, aortic valve disease and anomalous origin of the left coronary artery arising from the pulmonary artery. This case is a report of a 34-yr-old man with incomplete right bundle branch block and angiographically normal coronary arteries who was found to have reversible defects involving septal and inferoapical walls on stress-rest ²⁰¹Tl-chloride myocardial imaging.