When is myocardial scintigraphy indicated?

Myocardial scintigraphy allows the physician to assess myocardial perfusion under stress in the following situations:

• Coronary heart disease is suspected
• There is a need to evaluate the hemodynamic impact of areas of stenosis in patients with known coronary heart disease
• There is a need to differentiate between scar tissue and reversible perfusion defects (ischemia) under stress, eg. prior to or following surgical interventions involving the coronary arteries, such as PTCA or coronary artery bypass grafting.

What happens during myocardial scintigraphy?

The patient will be asked to exercise on a stationary bike/treadmill until they have reached their maximal exercise point. Shortly before this point is reached, a small amount of a radionuclide (thallium-201) is injected into a vein in the patient's arm. The radionuclide will accumulate in the patient's heart muscle cells and remain there for a short period of time. 



The first images will be taken immediately after the injection of thallium-201 using a technology known as SPECT (single photon emission computed tomography), which involves the use of a highly sensitive gamma camera that is capable of detecting the emitted radiation. The amount of thallium-201 accumulated will be significantly reduced in poorly-perfused areas of the heart muscle. 
Further SPECT images will be taken approximately three to four hours later. 

Areas of the heart muscle that accumulate less radioactivity under stress than at rest can be categorized as being affected by exercise-induced ischemia. Areas that are revealed as having a reduced capacity to accumulate thallium in both sets of images are likely to contain myocardial scar tissue, such as might be found after a myocardial infarction. Findings from both sets of images can also be used to identify which sections of the different coronary arteries are affected, although this is subject to certain limitations.

Myocardial scintigraphy is performed in order to find answers to very specific questions. The procedure is performed in cooperation with - and using the facilities provided by - Dr Karten Zschach's Nuclear Medicine Clinic. The Nuclear Medicine Clinic is located in the "Ärztehaus" building (Health Center), which is situated within the grounds of the hospital.



Dipl-med. Karsten Zschach
Ladeburger Straße 21
16321 Bernau bei Berlin
T: 03338 760-979