PMC5245854_01
A) Myocardial perfusion at rest (R) and stress (S) with
technetium-99m-Sestamibi (MIBI) to the right and rubidium-82 (82Rb) to
the left. Ischemia can be observed in most prominent inferolateral wall
in 82Rb. B) Left ventricular motility study (GATED-PET) shows apical
akinesia and severe hypomotility of the left ventricular inferior and
septal walls, with a decrease in ejection fraction under stress and the
presence of transient ischemic dilation (volumetric ratio between stress
and rest of 1.28).
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f1
Initially, the resting image was carried out; approximately 2 hours later, the stress imaging was performed (Figures 1 and 2) using dipyridamole as a stress agent.
(A) Myocardial blood flow measurements (mL/ min/g) at rest and under
stress, and coronary reserve in the territories of the left anterior
descending (LAD), circumflex (LCX) and right coronary (RCA) arteries
obtained with rubidium/positron-emission tomography. Observe the overall
reduction in myocardial blood flow and left ventricular (LV) reserve and
the territories of the three arteries (reserve <2.0). (B) Coronary
angiography showing 100% occlusion in the anterior descending,
circumflex and right coronary arteries, as well as the presence of grade
3 collateral circulation of multiple origin to the anterior descending
artery, grade 2 in the right coronary artery and grade 3 in the second
left marginal artery.
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Female patient, 63 years old, reported chest burning pain and dyspnea on exertion for 2 years and was submitted to CAT, which detected CAD (Figure 2). Initially, the resting image was carried out; approximately 2 hours later, the stress imaging was performed (Figures 1 and 2) using dipyridamole as a stress agent.