Characterization of Coronary Artery Obstruction Using Scintigraphy

Abstract

The heart is the pump responsible for maintaining adequate circulation of oxygenated blood around the vascular network of the body. It is a four- chamber pump, with the right side receiving deoxygenated blood from the body at low pressure and pumping it to the lungs (the pulmonary circulation) and the left side receiving oxygenated blood from the lungs and pumping it at high pressure around the body (the systemic circulation), and the heart itself supplied by Coronary arteries.This study was performed Alnilein Medical Center of Nuclear Medicine Department-Khartoum for 146 Ischemic heart disease patients associated with CAO, in period between year 2011 to 2014. The main objective of this study was Characterization of Coronary Artery Obstruction and Related Findings in Ischemic Heart Patients Using Cardiac Scintigraphy. For the Single Photon Emission Computed Tomography machine (SPECT) each imaged had been taken for each single case with guidance of ECG trigger, prepared by fasting overnight stopping any cardiac drug for 48 hours before imaging day, then at scan day injected with (20 mci) of Tc99m-MIBI, then patient wait for 45 min to 1 hr, in an isolation room, meanwhile should eat a Fatty meal after 15-20 min of injection, finally undergone scanned with SPECT system with ECG electrodes in his/her Chest region, the scan time is 17 min. The scanned image will be saved in a computer till be processed in good quality image. The data analyzed include upper, lower, right and left borders of the heart. The result showed that The means of the total scores found were: at rest = 12.9; after treadmill test = 19.3; after rehabilitation session = 15.1. There were statistically significant differences among them. An individual assessment showed that in 14 cases (53.8 %) hypo-uptake to some degree was identified during rehabilitation and in 12 cases (46.6%) it was not. Monitoring with the Holter system didn't show in any of the cases a ST segment depression equal or greater than 1mm. in conclusion this study is found to be very sensitive quantitative with adequate specificity for diagnosis Ischemia. And strongly recommended to be the first diagnostic line for such cases.