Letters to the Editor
To the Editor
Lima et al1 presented a 74-year-old man who showed extensive ischemia associated with cardiac arrest during exercise stress myocardial perfusion scintigraphy (MPI). The authors concluded that MPI after cardiac arrest is able to illustrate the pathophysiology of cardiac death.
To expand further on this point, we would like to add a rare experience in which MPI was able to show the consequence of cardiac death during cardiac arrest.
This is a 48-year-old woman who was referred to our department to be assessed for coronary artery disease. She had been hospitalized because of diabetic foot. She also had a history of hypertension.
The patient underwent dipyridamole 99mTc followed by gated myocardial perfusion imaging (MPI) 90 minutes later. During image acquisition (at frame 59 of 64), she showed cardiac arrest with asystolic cardiac rhythm. Cardiopulmonary resuscitation was started immediately, and it was successful.
The MPI showed decreased perfusion of most left ventricle segments and just preserved septal and anteroseptal walls (Fig. 1).
This is a rare report of cardiac arrest 1.5 hours after dipyridamole stress, which was recorded by a gamma camera.
This report emphasized the unique role of MPI in showing real-time cardiac arrest. In addition, it depicted the value of patient monitoring during the recovery period even after dipyridamole stress.
Hamid Javadi, MD
Golestan Research Center of
Gastroenterology and Hepatology
Golestan University of Medical Sciences
Majid Assadi, MD
The Persian Gulf Nuclear
Medicine Research Center
Bushehr University of Medical Sciences
1. Lima RS, De Lorenzo A, Nobrega B, et al.. Myocardial perfusion scintigraphy after cardiac arrest: on the pathophysiology of cardiac death. Clin Nucl Med
. 2012; 37: 387–389.