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Cardiac Stab Injury

A Fixed Perfusion Defect on Tc-99m Sestamibi SPECT

Hsieh, Hung-Jen, MD*; Kao, Pan-Fu, MD, ScM†‡; Huang, Hsuan-Li, MD§; Chou, Yu-Hsiang, MD

doi: 10.1097/RLU.0b013e3181c7be78
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A 46-year-old man complained of exertional dyspnea associated with chest tightness and was referred for a myocardial perfusion scan. The treadmill exercise test while achieving an 89% of target heart rate was negative for ischemia. The Tc-99m sestamibi myocardial perfusion single photon emission computed tomography (SPECT) revealed a fixed perfusion defect at the midportion of the anterior wall of the left ventricle (LV). Tracing back the clinical history, the patient admitted a cardiac stab injury about 12 years earlier. The left ventricular cine-angiography revealed akinesia in the anteroseptal wall of the LV with normal coronary angiography. It was concluded that a myocardial scar following a cardiac stab injury may not be associated with coronary artery damage.

From the *Department of Nuclear Medicine, Buddhist Tzu Chi General Hospital and Tzu Chi College of Technology, Hualien, Taiwan; †School of Medicine, Chung Shan Medical University, Taichung, Taiwan; ‡Department of Nuclear Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan; Departments of §Cardiology and ¶Nuclear Medicine, Buddhist Tzu Chi General Hospital, Taipei Branch, Taipei, Taiwan.

Received for publication August 18, 2008; accepted October 13, 2008.

Reprints: Pan-Fu Kao, MD, ScM, Department of Nuclear Medicine, Chung Shan Medical University Hospital, 110 Sec 1, Jianguo North Road, Taichung 40201, Taiwan. E-mail: pfkao@yahoo.com.tw.

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