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(Circulation. 2001;103:2315.)
© 2001 American Heart Association, Inc.

Images in Cardiovascular Medicine

Resolution of Stress-Induced Myocardial Ischemia During Aggressive Medical Therapy as Demonstrated by Single Photon Emission Computed Tomography Imaging

Robert A. O’Rourke, MD; Tuhin Chaudhuri, MD; Leslee Shaw, PhD; Daniel S. Berman, MD

From the Division of Cardiology (R.A.O.) and the Department of Radiology (T.C.), University of Texas Health Science Center, San Antonio; the Nuclear Medicine Service, South Texas Veterans Health Care System, San Antonio (T.C.); the Department of Health Policy and Management, Emory University, Atlanta, Ga (L.S.); and the University of California at Los Angeles School of Medicine, Los Angeles, Calif.

Correspondence to Robert A. O’Rourke, MD, Division of Cardiology, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78284. E-mail orourke@uthscsa.edu

A 50-year-old man with typical Canadian Cardiovascular Class III angina pectoris had coronary angiography that demonstrated an 80% mid-left anterior descending coronary artery stenosis. He had pharmacological stress single photon emission computed tomography imaging before and after 1 year of aggressive medical therapy alone (Figure). The medical therapy resulted in no angina, an LDL cholesterol level of 80 mg/dL, an HDL cholesterol level of 43 mg/dL, and controlled hypertension (116/80 mm Hg).

View larger version (97K): [in this window] [in a new window]   Figure 1. Baseline pharmacological stress (dipyridamole; top) and rest (thallium; bottom) single photon emission computed tomography images before medical therapy alone (left) and dual-isotope (thallium and technetium sestamibi) images with adenosine stress 1 year later (right). Complete resolution of the baseline stress-induced anterior wall defect is obvious.

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