Case Study 4

Patient History

Patient is a 58-year-old male who presented for pre-operative clearance with multiple risk factors including abnormal EKG, dyspnea, coronary atherosclerosis of native coronary artery, malaise and fatigue, unspecified peripheral vascular disease, and unspecified hyperlipidemia. Past medical history includes hypertension, elevated lipids, PTCA or stent, congestive heart failure and smoker.

Body Habitus

Height: 5’10”
Weight: 266lbs
BMI: 38 Kg/m2

SPECT Images

PET Images

Protocol Characteristics
Protocol SPECT PET
Mode of Stress Treadmill Lexiscan
Clinical Response Non-ischemic Non-ischemic
Blood Pressure Response Normal Normal
ECG Response Negative Negative
Radiopharmaceutical Tc-99m Tetrofosmin Rubidium-82
Rest/Stress Dose 10mCi/30mCi 52.4mCi/52.2mCi
Gated Yes Yes


Patient is read as equivocal on SPECT and positive with cardiac PET image. Subsequent imaging was equivocal. PET scan shows a moderate reversible defect in the mid-inferior wall suggestive of ischemia.

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