Value of positive myocardial infarction imaging in coronary care units.

Abstract

Positive myocardial imaging was undertaken on 120 unselected patients admitted to a coronary care unit with clinical suspicion of acute myocardial infarction. Multipurpose mobile gamma-cameras were used for serial imaging after administration of 99mtechnetium-labelled imidodiphosphonate, a low-cost radiopharmaceutical that is 97% specific for myocardial necrosis, with myocardial uptake and blood clearance most suitable for myocardial imaging. The sensitivty of detection was 94% for patients whose infarction was unequivocal on the ECG; when the presence of raised enzyme concentrations was also used as a criterion for myocardial necrosis, the overall sensitivity for all 120 patients remained 94%. In 73 patients (61%), whose ECGs were unhelpful or difficult to interpret, scintigraphy allowed infarction to be diagnosed in 11 (15%) and to be excluded in five (7%). In 32 (44%) of this group whose ECGs were totally uninterpretable due to previous myocardial damage or disorders of electrical activation, scintigraphy provided confirmation of a diagnosis that otherwise rested only on whether enzyme concentrations were raised. Myocardial imaging is thus a useful technique that permits more definite diagnosis in patients for whom ECG and enzyme data are uncertain.

• Authors: S P Joseph, A V Pereira-Prestes, P J Ell, R Donaldson, W Somerville, R W Emanuel
• Journal: British medical journal (Br Med J) Vol. 1 Issue 6160 Pg. 372-4 (Feb 10 1979) ISSN: 0007-1447 [Print] England
• PMID: 761017 (Publication Type: Comparative Study, Journal Article)

Chemical References

• Diphosphonates
• Technetium

Topics

• Acute Disease
• Clinical Enzyme Tests
• Coronary Care Units
• Diphosphonates
• Electrocardiography
• Humans
• Myocardial Infarction (diagnosis, diagnostic imaging)
• Radionuclide Imaging
• Technetium