Impact of immediate and delayed myocardial scintigraphy on therapeutic decisions in suspected acute myocardial infarction

Finn Erland Nielsen, Erik Kjøller, Søren Loumann Nielsen, J Carlsen, J T Møller, K Hvid-Jacobsen, P F Jensen, Knud Skagen, Inge-Lis Kanstrup

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Abstrakt

Early myocardial scintigraphic imaging has become technically feasible in patients admitted to hospital with suspected acute myocardial infarction. After prompt injection of 99mTc-sestamibi, subsequent scintigraphic imaging of perfused myocardium can be performed. During a 5-month period, 237 patients were admitted to the coronary care unit of a district hospital on suspicion of acute ischaemic syndrome, and injection of 99mTc-sestamibi for the performance of myocardial scintigraphy was carried out in 134 patients, on average 2 h after onset of symptoms. The investigation was repeated in 126 patients, on average 18 h after the injection. Three planar views were taken in the coronary care unit with a mobile gamma camera. The prevalence of acute myocardial infarction was 53%. The predictive value at the first scintigraphic imaging for a positive or negative test for myocardial infarction 54% and 56%, respectively. Even exclusion of patients with a previous infarction did not increase the diagnostic validity. The predictive value of a negative test, 77%, at the second scintigraphy was still insufficient to make immediate therapeutic decisions. Myocardial scintigraphy performed early, on suspicion of acute myocardial infarction, cannot therefore be used routinely as a diagnostic test prior to intervention in unselected patients because some 90% of this patient group have myocardial perfusion defects.

OriginalsprogEngelsk
TidsskriftEuropean Heart Journal
Vol/bind16
Udgave nummer7
Sider (fra-til)909-13
Antal sider5
ISSN0195-668X
DOI
StatusUdgivet - 1995

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