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  1. Article ; Online: Myocardial ischemia in patients with large prior infarction

    Talal Asif, MD / Rami Doukky, MD, MSc, MBA

    Radiology Case Reports, Vol 18, Iss 2, Pp 538-

    Clinical decision making and review of literature

    2023  Volume 544

    Abstract: Myocardial perfusion imaging (MPI) with single photon emission computed tomography (SPECT) or positron emission tomography (PET) is a widely used technique for the evaluation of coronary artery disease (CAD). Interpreting physicians rely on regional ... ...

    Abstract Myocardial perfusion imaging (MPI) with single photon emission computed tomography (SPECT) or positron emission tomography (PET) is a widely used technique for the evaluation of coronary artery disease (CAD). Interpreting physicians rely on regional variations in myocardial radiotracer uptake between rest and stress images to identify hemodynamically significant epicardial coronary artery stenosis. However, interpretation of MPI is very difficult in patients with large infarcts where there is no scintigraphically normal reference myocardium for comparison. In these patients, the stress and rest images appear similar due to balanced ischemia in the non-infarct territory. There are no clear guidelines on how to approach these cases. We present a case of MPI with a large right coronary artery territory (RCA) infarct where the left main (LM) coronary artery territory has no relative comparator and the images looked the same on stress and rest. However, the patient had multiple high-risk ancillary findings including electrocardiographic (ECG) changes with regadenoson, transient ischemic dilatation (TID), large severe inferior infarct, low myocardial blood flow (MBF) and myocardial flow reserve (MFR), but most notably increased right ventricular (RV) uptake on the stress images that was a subtle clue that we were dealing with LM equivalent in non-infarct zone. The coronary angiogram confirmed our findings. Through our case, we provide a comprehensive approach and review of literature on how to approach such challenging encounters.
    Keywords Multivessel coronary artery disease ; Rubidium-82 positron emission tomography ; Transient ischemic dilatation ; Myocardial blood flow ; Myocardial flow reserve ; Medical physics. Medical radiology. Nuclear medicine ; R895-920
    Subject code 610
    Language English
    Publishing date 2023-02-01T00:00:00Z
    Publisher Elsevier
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  2. Article ; Online: Mechanical pulmonic valve thrombosis

    Ahmed A. Kolkailah, MD, MSc / Talal Asif, MD / Fady H. Iskander, MD, MSc / Javier Gomez-Valencia, MD, MSc, FACC / Saurabh Malhotra, MD, MPH, FACC

    Radiology Case Reports, Vol 17, Iss 9, Pp 3270-

    expanding role of cardiac CT and multimodality imaging

    2022  Volume 3273

    Abstract: We report a case of a 44-year-old man with a clinical history of Tetralogy of Fallot status post staged surgical correction with mechanical pulmonic valve replacement who presented with progressive exertional dyspnea in the setting of non-compliance with ...

    Abstract We report a case of a 44-year-old man with a clinical history of Tetralogy of Fallot status post staged surgical correction with mechanical pulmonic valve replacement who presented with progressive exertional dyspnea in the setting of non-compliance with anticoagulation. In the context of this suggestive clinical presentation, the diagnosis of mechanical pulmonic valve thrombosis (MPVT) was made possible via multimodality imaging, including transthoracic echocardiogram and cardiac computed tomography angiography. Due to the uncommon nature of the condition, the patient was treated with systemic thrombolysis and anticoagulation using evidence-based guidelines, largely extrapolated from left-sided mechanical valve thrombosis. Our case underscores the importance of anticoagulation in MPVT and recognizing the features of MPVT on clinical history, physical examination, and multimodality imaging. It is essential to understand the pivotal role of multimodality imaging in the assessment of MPVT and realize the limitations of available data regarding the management of MPVT in the current era.
    Keywords Mechanical pulmonic valve thrombosis ; Cardiac computed tomography angiography ; Multimodality imaging ; Anticoagulation ; Systemic thrombolysis ; Evidence-based guidelines ; Medical physics. Medical radiology. Nuclear medicine ; R895-920
    Subject code 610
    Language English
    Publishing date 2022-09-01T00:00:00Z
    Publisher Elsevier
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

    Full text online

    More links

    Kategorien

    Inter-library loan at ZB MED

    Your chosen title can be delivered directly to ZB MED Cologne location if you are registered as a user at ZB MED Cologne.

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