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Spontaneous Silent Myocardial Ischemia Assessed by Technetium-99m-Sestamibi Imaging

Nuclear Cardiology Laboratory, Division of Cardiology, Memorial Hospital of Rhode Island, Pawtucket
Brown University School of Medicine, Providence, Rhode Island

Correspondence: For correspondence or reprints contact: Gary V. Heller, MD, PhD, Director, Nuclear Cardiology, Division of Cardiology, Memorial Hospital of Rhode Island, 111 Brewster St., Pawtucket, RI 02860

ABSTRACT

We report on an 80-yr-old patient with a history of inferior myocardial infarction. The patient was injected with 15 mCi of ^99mTc-sestamibi when an electrocardiogram revealed new asymptomatic inferolateral ST-segment depressions. A second ^99mTc study was performed 72 hr after the initial injection and after ST-segment changes had resolved. Scintigraphic acquisitions using SPECT revealed a large reduction in photon activity in the inferolateral and inferoposterior walls with 70%–80% normalization. Therefore, ^99mTc-sestamibi imaging is useful in assessing asymptomatic silent myocardial ischemia.