See. Cardiology.

Case C

Evaluation for non-anginal chest pain, dyspnea and palpitations


Patient History
58 year-old male

Indication
Evaluation for non-anginal chest pain, dyspnea and palpitations. Cardiac risk factors include hypertension and diabetes with family history of ischemic heart disease and obesity.

PET Protocol
Myocardial perfusion PET study following IV administration of 60 mCi of Rubidium-82 at rest and 60 mCi of Rubidium-82 during peak Dypiridamole stress, respectively. Gated images were obtained at rest and during peak stress.

CT Protocol
Breath-hold cardiac CT was performed using the Discovery VCT scanner with 0.35 sec rotation time. Contrast injection was timed and the patient received 60 cc at a rate of 5 cc/sec. Average heart rate was 65 bpm.

Impression
The PET perfusion scan demonstrated no evidence of ischemia or scar tissue. The gated PET scan demonstrated normal global left ventricular function. There is no evidence of coronary artery calcification. The PET/CT test results are normal, suggesting no evidence of flow-limiting coronary artery disease.


Case D

Evaluation for non-anginal chest pain, dyspnea and palpitations


Patient History
63 year-old male
67 in, 210 lbs

Indication
Evaluation for coronary artery disease, typical chest pain and increasing fatigue with exertion.

PET Protocol
Myocardial perfusion PET study following IV administration of 61 mCi of Rubidium-82 at rest and 60 mCi of Rubidium-82 during peak Adenosine stress, respectively. Gated images were obtained at rest and during peak stress.

CT Protocol
Breath-hold cardiac CT was performed using the Discovery VCT scanner with 0.35 sec rotation time. Contrast injection was timed and the patient received 60 cc at a rate of 5 cc/sec. Average heart rate was 62 bpm.

Impression
PET perfusion scan demonstrated a small defect in the anterolateral wall that is reversible. CTA showed a mild complex plaque with non-obstructive stenosis in the LCX. The first obtuse marginal branch shows a stent. The left main length shows severe calcification with a <50% luminal stenosis. The first diagonal branch shows a large vessel with a <50% ostial stenosis. The first RPL of the RCA demonstrated a stent that is patent. Follow-up was recommended.