Okano A, Itoh K, Nagata K, Kawasaki T, Yoneyama S, Katoh S
Division of Cardiovascular Medicine, Murakami Memorial Hospital, Asahi University.
Kaku Igaku. 1998 Nov;35(9):871-6.
Patients with acute coronary syndrome require accurate diagnosis and treatment. We found that emergency myocardial scintigraphy with 99mTc-tetrofosmin was useful for diagnosis in 2 patients with acute coronary syndrome. The first patient was a 66-year-old man, who was hospitalized with chest discomfort at rest. Blood tests, electrocardiography, and echocardiography revealed no unusual findings. Myocardial scintigraphy with 99mTc-tetrofosmin disclosed moderately reduced uptake extending from the anterior wall to the apex. Coronary arteriography revealed 75% stenosis of the left main trunk. He was diagnosed as having unstable angina pectoris and coronary bypass surgery was performed. The second patient was a 61-year-old man, who was hospitalized with chest discomfort. Slight leukocytosis and flat T waves in leads V5 and V6 on electrocardiogram were detected, but echocardiographic findings were not abnormal. Myocardial scintigraphy with 99mTc-tetrofosmin revealed a defect in the posterolateral wall. Coronary arteriography showed total obstruction of #14, and a diagnosis of acute myocardial infarction was established. PTCA of #14 was performed to achieve reperfusion.
急性冠状动脉综合征患者需要准确的诊断和治疗。我们发现，采用99mTc-替曲膦进行急诊心肌闪烁扫描对2例急性冠状动脉综合征患者的诊断很有用。首例患者为一名66岁男性，因静息时胸部不适入院。血液检查、心电图和超声心动图均未发现异常。采用99mTc-替曲膦进行心肌闪烁扫描显示，从前壁到心尖摄取呈中度降低。冠状动脉造影显示左主干狭窄75%。他被诊断为不稳定型心绞痛，并接受了冠状动脉搭桥手术。第二例患者为一名61岁男性，因胸部不适入院。检测到白细胞轻度增多以及心电图V5和V6导联T波低平，但超声心动图检查结果无异常。采用99mTc-替曲膦进行心肌闪烁扫描显示后外侧壁有缺损。冠状动脉造影显示14号血管完全阻塞，确诊为急性心肌梗死。对14号血管进行了经皮冠状动脉腔内血管成形术以实现再灌注。
