Perfusion imaging in ischemic heart disease.

Myocardial perfusion imaging with thallium-201 has been used extensively for many years in the evaluation of ischemic heart disease. It is a valuable adjunct to exercise treadmill testing and is especially helpful in evaluating cardiac perfusion in patients who have abnormal resting electrocardiograms, who are unable to exercise, and whose clinical history and exercise test results are discordant. Perfusion imaging is useful for both diagnosis and prognosis in patients with coronary artery disease. In patients unable to exercise, the coronary vasodilators dipyridamole and adenosine may be used in conjunction with thallium imaging. Two recently approved technetium agents, sestamibi and teboroxime, may be used in place of thallium.