TY - JOUR
T1 - Acute subendocardial myocardial infarction
T2 - Its detection by Tc-99m-stannous pyrophosphate myocardial scintigraphy
AU - Pulido, J. I.
AU - Parkey, R. W.
AU - Lewis, S. E.
AU - Buja, L. M.
AU - Bonte, F. J.
AU - Dehmer, G.
AU - Stone, M. J.
AU - Willerson, J. T.
PY - 1980/1/1
Y1 - 1980/1/1
N2 - Sixty-two patients hospitalized because of prolonged chest pain and initial electrocardiographic (ECG) changes of ST depression and T-wave inversion suggestive of acute subendocardial myocardial infarction were evaluated to determine the ability of Tc-99m-stannous pyrophosphate myocardial scintigraphy to detect the presence or absence of acute subendocardial myocardial necrosis. Three groups of patients were designated. Group A consisted of eight patients (13%) who developed reduction of R-waves of more than 25% or new Q-waves broader than 0.03 seconds; of these patients with acute transmural myocardial infarction, all had well-localized, abnormal scintigrams. Group B consisted of 30 patients with ECG changes and subsequent enzymatic documentation, including elevated serum creatine kinase-B levels as determined by radioimmunoassay, of the presence of acute subendocardial myocardial infarction. Of these, 27 had abnormal scintigrams, including 18 with well-localized patterns and nine with 'poorly localized' patterns. Group C consisted of 24 patients (39%) with chest pain, but without enzymatic documentation of the presence of acute myocardial infarction (acute coronary insufficiency). Eight of these had abnormal scintigrams, including one with a well-localized pattern and seven with 'poorly localized' patterns. In four of the latter, the scintigrams were 'persistently positive' several weeks to months after a previous myocardial infarct. Serial myocardial imaging will be necessary to identify such patients.
AB - Sixty-two patients hospitalized because of prolonged chest pain and initial electrocardiographic (ECG) changes of ST depression and T-wave inversion suggestive of acute subendocardial myocardial infarction were evaluated to determine the ability of Tc-99m-stannous pyrophosphate myocardial scintigraphy to detect the presence or absence of acute subendocardial myocardial necrosis. Three groups of patients were designated. Group A consisted of eight patients (13%) who developed reduction of R-waves of more than 25% or new Q-waves broader than 0.03 seconds; of these patients with acute transmural myocardial infarction, all had well-localized, abnormal scintigrams. Group B consisted of 30 patients with ECG changes and subsequent enzymatic documentation, including elevated serum creatine kinase-B levels as determined by radioimmunoassay, of the presence of acute subendocardial myocardial infarction. Of these, 27 had abnormal scintigrams, including 18 with well-localized patterns and nine with 'poorly localized' patterns. Group C consisted of 24 patients (39%) with chest pain, but without enzymatic documentation of the presence of acute myocardial infarction (acute coronary insufficiency). Eight of these had abnormal scintigrams, including one with a well-localized pattern and seven with 'poorly localized' patterns. In four of the latter, the scintigrams were 'persistently positive' several weeks to months after a previous myocardial infarct. Serial myocardial imaging will be necessary to identify such patients.
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U2 - 10.1097/00003072-198005000-00003
DO - 10.1097/00003072-198005000-00003
M3 - Article
C2 - 7371345
AN - SCOPUS:0018897233
SN - 0363-9762
VL - 5
SP - 191
EP - 195
JO - Clinical Nuclear Medicine
JF - Clinical Nuclear Medicine
IS - 5
ER -