MYOCARDIAL SPECT PERFUSION STUDY:  RESTING Tc99m TETROFOSMIN (MYOVIEW)

DATE: 2/2/2006

PROCEDURE: After injection of technetium 99m tetrofosmin (Myoview), resting SPECT images of the heart were acquired.

DOSE:  99m Tc tetrofosmin (Myoview) [8] mCi

COMPARISON: None

CLINICAL HISTORY:  The patient is a [...]-year-old [fe]male with a history of [...]. Now referred to Nuclear Medicine for a myocardial perfusion study at rest.

FINDINGS:

MYOCARDIAL PERFUSION STUDY:

PERFUSION AT REST: Normal perfusion to all walls of the left ventricular myocardium. Mild decrease in tracer activity in the proximal to mid inferior wall. Moderate to severely decreased tracer activity in the proximal to distal inferior wall extending into the inferoapical region. Homogeneous normal activity in the remainder of the left ventricular myocardium.
 
Left ventricular chamber size: Normal.

Comparison with the previous myocardial perfusion scan indicates that there has been no significant interval change.

CONCLUSIONS: 

1. Normal rest perfusion study with no scintigraphic evidence for abnormal tracer activity.

2. The left ventricle is of normal size. 
 
3. No significant interval change compared to the previous myocardial perfusion scan.

4. Please note that due to lack of gated stress perfusion study, stress-induced ischemia, wall motion and left ventricular function cannot be evaluated.

1. Fixed perfusion defect in the inferior wall extending into the apex which is consistent with prior infarction in the RCA territory. There is no evidence for stress inducible ischemia.

2. Enlarged LV size with wall motion abnormalities as noted above. Estimated left ventricular ejection fraction is [...]%.

3. The above findings suggest a non-ischemic process as the underlying cause of the patient's congestive heart failure.

1. This is an abnormal rest/stress myocardial perfusion study with a partially reversible perfusion defect of moderate severity in the mid to distal anterior wall including the apex, consistent with stress-induced ischemia in the LAD territory.  The partial reversibility suggests myocardial damage in the antero-apical region.

2. The left ventricle is moderately enlarged and demonstrates decreased function with wall motion abnormalities described above, and an estimated ejection fraction of 21%.

Thank you for referring this patient to the UCLA Nuclear Medicine Clinic.

I, [...], M.D., Ph.D., have reviewed this Nuclear Medicine study personally, and am in full agreement with the findings of the report presented here.