A Shot to the Heart

Excerpt

The appropriate identification of patients at increased risk of major adverse cardiovascular events is a continued goal and major challenge for contemporary cardiovascular imaging. Single-photon emission computed tomography (SPECT) cardiovascular stress testing is a well-established imaging modality for the assessment of coronary artery disease (CAD). SPECT imaging relies on absorption of incident gamma photons emitted from an injected radioisotope. Extra-cardiac artifacts have been known to potentially create artifactually increased uptake in adjacent myocardium that could mask a perfusion defect or be misinterpreted as decreased uptake in remote myocardium. Prior studies1 have noted that metals within intra-cardiac pacemakers and implantable cardioverter-defibrillator (ICD) leads can result in overestimation of counts. Correct interpretation of cardiovascular SPECT images requires a thorough patient history. …