Ischemia
Case Study: Ischemia
Patient:
63 Y/O male
BMI: 36Medical History:
Evaluate known CAD,m HTN, Dyslipidemia, CABGProcedure:
Low dose rest / high dose stress
Stress type: Exercise
Abnormal ECGDiagnosis:
Lateral wall ischemia
55% ejection fractionImages within this presentation have been provided courtesy of the following sites:
Cardiology Associates of Fairfield County; Stamford, CT, Dr M. Heiman. Long Island Jewish Medical Center; New Hyde Park, NY. Mayo Clinic; Rochester, MN. Ottawa Heart Institute; Ottawa, Canada, Dr Iftikhar Al. Rambam Medical Center; Haifa, IsraelThallium
Case Study: Thallium- Negative for Ischemia
Patient:
59 Y/O maleMedical History:
H/O smoking, Dyslipidemia, positive treadmill test
Evaluate for ischemiaProcedure:
Bruce protocol 9 minutes, 28 seconds. Peak HR 153 BPM (85% max)
124.6 MBq (3.67 mCi) Tl201Diagnosis:
Normal EF (65%), LV size and wall motion
No significant ischemiaImages within this presentation have been provided courtesy of the following sites:
Cardiology Associates of Fairfield County; Stamford, CT, Dr M. Heiman. Long Island Jewish Medical Center; New Hyde Park, NY. Mayo Clinic; Rochester, MN. Ottawa Heart Institute; Ottawa, Canada, Dr Iftikhar Al. Rambam Medical Center; Haifa, IsraelDual Isotope
Case Study: Dual Isotope- Abnormal
Patient:
67 Y/O maleMedical History:
202 lbs
CAD, anterior wall MI, Stent, Hyperlipidemia
Evaluate for ischemiaProcedure:
Modified Bruce protocol 7 minutes, 40 seconds. 12.8 METS. Peak HR 139 BPM(91% max).
No Significant ST depression
Stress: 22.7 mCi Tc99m Sestamibi
Rest: 2.84 mCi Tl201Diagnosis:
Abnormal perfusion pattern. Antero-apical and distal septal infarct with reduced LV Function, Abnormal EF (37%)Images within this presentation have been provided courtesy of the following sites:
Cardiology Associates of Fairfield County; Stamford, CT, Dr M. Heiman. Long Island Jewish Medical Center; New Hyde Park, NY. Mayo Clinic; Rochester, MN. Ottawa Heart Institute; Ottawa, Canada, Dr Iftikhar Al. Rambam Medical Center; Haifa, IsraelProne Stress
Case Study: Prone Stress- Reversible Diaphragm Attenuation
Patient:
44 Y/O male
Weight: 97.5kg (215lbs)Medical History:
No complaints
Had abnormal baseline EKG, smoker, overweight, family history of CADProcedure:
One Day Reverse ProtocolResults:
Inferior wall defect on stress images
Prone images are normal
Indeterminate EKG stress test due to baseline EKG abnormalities
and normal imagesDiagnosis:
Normal with Inferior wall diaphragmatic attenuationImages within this presentation have been provided courtesy of the following sites:
Cardiology Associates of Fairfield County; Stamford, CT, Dr M. Heiman. Long Island Jewish Medical Center; New Hyde Park, NY. Mayo Clinic; Rochester, MN. Ottawa Heart Institute; Ottawa, Canada, Dr Iftikhar Al. Rambam Medical Center; Haifa, Israel