Anatomical correlation between positive technetium-99 myocardial perfusion scan for ischemia and coronary arteriography in patients with suspected coronary artery disease
Description
Cardiovascular disease is the leading cause of death in developed countries. In Costa Rica, the main cause of death coincidentally is also cardiovascular disease, within this large group of diseases, ischemic heart disease secondary to coronary artery disease is the most frequent pathology. The definitive diagnosis, and most of the time the treatment of this disease is done through percutaneous coronary angiography; However, it is an invasive procedure, which is not exempt from complications, such as hematomas of the puncture site, infarction, coronary perforation, cardiac tamponade and death; in addition to the harmful effects on kidney function that the contrast medium used has. Therefore, an intermediate study is necessary to select the patients with the greatest probability of benefit from a coronary arteriography and who also have a safety profile that is equal to or less than that of coronary arteriography. The myocardial perfusion scintigraphy is a study that allows identifying patients with coronary disease with a sensitivity greater than 90% and a specificity greater than 75%. However, myocardial perfusion grammagraphy also has some limitations that may reduce the sensitivity and specificity of the test, such as obesity, blockade of the left bundle of His bundle, dilated or hypertrophic cardiomyopathy, prominent mammary glands. The present work tries to look for the anatomical correlation of the scintigraphy compared with the coronary angiography, to identify false positives, with the aim of seeing those patients who are likely to have a false positive and to avoid being subjected to an arteriography; on the contrary, find the clinical profile in which the patient benefits and the myocardial perfusion study is well indicated and present antecedents for the possible elaboration of a clinical practice protocol for the diagnosis of coronary heart disease
Availability note (English)
Available from Biblioteca Luis Demetrio Tinoco, Universidad de Costa Rica; Also available on line: http://repositorio.sibdi.ucr.ac.cr:8080/jspui/bitstream/123456789/4842/1/41749.pdfAbstract (Spanish)
La enfermedad cardiovascular es la principal causa de muerte en los paises desarrollados. En Costa Rica la principal causa de muerte coincidentemente tambien es la enfermedad cardiovascular, dentro de este grupo grande de enfermedades, la cardiopatia isquemica secundaria a enfermedad arterial coronaria es la patologia mas frecuente. El dianostico definitivo, y en su mayoria de las veces el tratamiento de dicha enfermedad se hace a traves de la angiografia coronaria percutanea; sin embargo es un procedimiento invasivo, que no esta exento de complicaciones, tales como hematomas del sitio de puncion, infarto, perforacion coronaria, taponamiento cardiaco y muerte; ademas de los efectos nocivos sobre la funcion renal que tiene el medio de contraste utilizado. Por lo que es necesario un estudio intermedio que permita seleccionar a los pacientes con mayor probabilidad de un beneficio de una arteriografia coronaria y que ademas tenga un perfil de seguridad que sea igual o menor a la arteriografia coronaria. La gammagrafia de perfusion miocardica es un estudio que permite identificar pacientes con enfermedad coronaria con una sensibilidad mayor al 90% y una especificidad mayor al 75%. Sin embargo la grammagrafia de perfusion miocardica tambien tiene algunas limitaciones que pueden disminuir la sensibilidad y la especificidad de la prueba, como es la obesidad, el bloqueo de la rama izquierda del haz de His, miocardiopatia dilatada o hipertrofica, glandulas mamarias prominentes. El presente trabajo pretende buscar la correlacion anatomica de la gammagrafia comparado con la coronariografia, identificar falsos positivos, con el objetivo de ver a aquellos pacientes que tienen probabilidad de tener un falso positivo y evitar que sea sometido a una arteriografia; del modo contrario encontrar el perfil clinico en el que el paciente se beneficia y esta bien indicada el estudio de perfusion miocardica y presentar antecedentes para la posible elaboracion de un protocolo de practica clinica del diagnostico de la enfermedad coronaria. (autor)Additional details
Additional titles
- Original title (Spanish)
- Correlacion anatomica entre la gammagrafia de perfusion miocardica con tecnecio 99 positiva por isquemia y la arteriografia coronaria, en pacientes con sospecha de enfermedad arterial coronaria
Publishing Information
- Imprint Place
- San Jose (Costa Rica)
- Imprint Pagination
- [24 p.]
INIS
- Country of Publication
- Costa Rica
- Country of Input or Organization
- Costa Rica
- INIS RN
- 51120701
- Subject category
- S62: RADIOLOGY AND NUCLEAR MEDICINE;
- Resource subtype / Literary indicator
- Thesis, Non-conventional Literature
- Descriptors DEI
- ARTERIES; BIOMEDICAL RADIOGRAPHY; BLOOD FLOW; CARDIOVASCULAR DISEASES; CORONARIES; DIAGNOSIS; DIAGNOSTIC TECHNIQUES; HEART; ISCHEMIA; MYOCARDIUM; RADIOLOGY; SCINTISCANNING; SIDE EFFECTS; TECHNETIUM; VASCULAR DISEASES
- Descriptors DEC
- ANEMIAS; ARTERIES; BLOOD VESSELS; BODY; CARDIOVASCULAR DISEASES; CARDIOVASCULAR SYSTEM; COUNTING TECHNIQUES; DIAGNOSTIC TECHNIQUES; DISEASES; ELEMENTS; HEART; HEMIC DISEASES; MEDICINE; METALS; MUSCLES; NUCLEAR MEDICINE; ORGANS; RADIOISOTOPE SCANNING; RADIOLOGY; REFRACTORY METALS; SYMPTOMS; TRANSITION ELEMENTS; VASCULAR DISEASES
Optional Information
- Notes
- Tab., ill., fig., refs.