Technetium 99m stannous pyrophosphate was utilized for myocardial imaging in 202 patients admitted to the hospital with chest pain of uncertain etiology. 101 Patients had clinical and evolved electrocardiographic and enzymatic evidence of acute myocardial infarction. Ninety six of these 101 patients had increased myocardial uptake of the technetium stannous pyrophosphate and positive myocardial scintigrams; there was nearly precise correlation between the ECG and myocardial imaging localization of the area of infarction for acute transmural myocardial infarctions. In the 5 patients with negative myocardial images the scintigrams were obtained after 7 or more days had elapsed following the myocardial infarction. In the remaining 101 patients no clinical, ECG, or enzymatic evidence of infarction developed; 92 of these patients had negative myocardial scintigrams. Seven of the remaining 9 patients were admitted with 'unstable angina pectoris' and despite the absence of diagnostic ECG and enzyme evolution each of these patients had faintly and diffusely positive myocardial scintigrams. The remaining 2 patients had positive myocardial scintigrams but no definite ECG or enzymatic evidence of acute myocardial infarction. Thus, the technetium pyrophosphate imaging technique is safe, inexpensive and correlates well with ECG and enzyme identification of the presence of infarction and with ECG localization of myocardial infarction. In addition, the positive myocardial scintigrams in some patients with 'unstable angina' suggest that there may be limited myocardial necrosis that is ordinarily undetected by ECG and enzymes in these patients. The incidence of false positive and false negative scintigrams appears to be small.
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
- Physiology (medical)