Case 14 A 62-year-old man with a history of left bundle branch block (LBBB) diagnosed 25 years earlier is now referred for cardiology consultation because of an abnormal gated SPECT MPI at an outside facility. By report, there are fixed inferior and septal defects suggestive of infarction, as well as severe LV systolic dysfunction (LVEF = 14%). He has no cardiac symptoms despite vigorous physical activity. He has no coronary artery disease (CAD) risk factors. His mother had an “enlarged heart.” 12-Lead ECG The baseline ECG demonstrates normal sinus rhythm, left-axis deviation, and LBBB. Following are options for identification of cardiomyopathy due to CAD (ischemic cardiomyopathy): A. Dobutamine echo B. Vasodilator stress PET MPI C. Coronary CT angiography D. Invasive coronary angiogram The patient preferred to avoid invasive coronary angiography. After discussion of the available options, he elected to undergo coronary CT angiography. Functional (Gated) CT Left Ventricular Angiogram The left ventricular cavity volumes were markedly elevated, and left ventricular systolic function was severely reduced, with a computed LVEF of 18%. Severe global hypokinesis was observed, consistent with ischemic or nonischemic cardiomyopathy. Coronary Calcium Score (CCS) • LM = 9 Only gold members can continue reading. Log In or Register to continue Share this:Click to share on Twitter (Opens in new window)Click to share on Facebook (Opens in new window) Related Related posts: Cardiac Neurotransmission Imaging: Single-Photon Emission Computed Tomography 6 18 Digital/Fast SPECT: Systems and Software Stay updated, free articles. Join our Telegram channel Join Tags: Clinical Nuclear Cardiology State of the Art and Future Direction Jun 11, 2016 | Posted by admin in CARDIOLOGY | Comments Off on 14 Full access? Get Clinical Tree
Case 14 A 62-year-old man with a history of left bundle branch block (LBBB) diagnosed 25 years earlier is now referred for cardiology consultation because of an abnormal gated SPECT MPI at an outside facility. By report, there are fixed inferior and septal defects suggestive of infarction, as well as severe LV systolic dysfunction (LVEF = 14%). He has no cardiac symptoms despite vigorous physical activity. He has no coronary artery disease (CAD) risk factors. His mother had an “enlarged heart.” 12-Lead ECG The baseline ECG demonstrates normal sinus rhythm, left-axis deviation, and LBBB. Following are options for identification of cardiomyopathy due to CAD (ischemic cardiomyopathy): A. Dobutamine echo B. Vasodilator stress PET MPI C. Coronary CT angiography D. Invasive coronary angiogram The patient preferred to avoid invasive coronary angiography. After discussion of the available options, he elected to undergo coronary CT angiography. Functional (Gated) CT Left Ventricular Angiogram The left ventricular cavity volumes were markedly elevated, and left ventricular systolic function was severely reduced, with a computed LVEF of 18%. Severe global hypokinesis was observed, consistent with ischemic or nonischemic cardiomyopathy. Coronary Calcium Score (CCS) • LM = 9 Only gold members can continue reading. Log In or Register to continue Share this:Click to share on Twitter (Opens in new window)Click to share on Facebook (Opens in new window) Related Related posts: Cardiac Neurotransmission Imaging: Single-Photon Emission Computed Tomography 6 18 Digital/Fast SPECT: Systems and Software Stay updated, free articles. Join our Telegram channel Join Tags: Clinical Nuclear Cardiology State of the Art and Future Direction Jun 11, 2016 | Posted by admin in CARDIOLOGY | Comments Off on 14 Full access? Get Clinical Tree
