ASSESSMENT OF ROUTINE STRESS-REST TC99M-MIBI MYOCARDIAL PERFUSION SCINTIGRAPHY FOR ATYPICAL ANGINA PATIENTS

Abstract

Background: Myocardial perfusion scintigraphy (MPS) using technetium-99m sestamibi (Tc-99m MIBI) is a well-established non-invasive imaging technique for assessing myocardial ischemia and coronary artery disease (CAD). Atypical angina, presenting with non-classical symptoms such as epigastric discomfort, jaw or arm pain, and chest tightness, poses diagnostic challenges due to its intermediate risk for CAD. Identifying myocardial ischemia in these patients is crucial for early intervention and risk stratification. This study evaluates the diagnostic utility of routine stress-rest Tc-99m MIBI MPS in patients with atypical angina.

Objective: To assess the effectiveness of stress-rest Tc-99m MIBI myocardial perfusion scintigraphy in detecting myocardial ischemia and evaluating cardiac function in patients presenting with atypical angina.

Methods: This analytical cross-sectional study was conducted over four months at the Punjab Institute of Cardiology, Lahore. A total of 47 patients with atypical angina and inconclusive coronary angiography findings were included. Data on age, gender, medical history, heart rate, blood pressure, and Tc-99m MIBI doses were collected. Patients with contraindications to Tc-99m MIBI or stress testing were excluded. Heart rate and blood pressure were recorded at rest and under stress conditions. Statistical analysis was performed using descriptive methods.

Results: Among 47 participants, 68.1% were female. Age distribution was 12.8% in 30–40 years, 34.0% in 41–50 years, 34.0% in 51–60 years, and 19.1% in 61–70 years. Medical history showed 44.7% had no symptoms, 19.1% had palpitations, 14.9% were obese, 12.8% had shortness of breath, 6.4% had diabetes, and 2.1% were smokers. Resting heart rate was high (>85 bpm) in 70.2% of patients, increasing to 80.9% under stress. Hypertension Stage 2 was observed in 34.0% at rest and 83.0% under stress. Tc-99m MIBI doses ranged from 400–450 MBq in 61.7% of patients.

Conclusion: Tc-99m MIBI myocardial perfusion scintigraphy proves to be a valuable diagnostic tool in detecting ischemia and myocardial perfusion abnormalities in patients with atypical angina. Its use facilitates early diagnosis and effective management of CAD, particularly in cases where traditional diagnostic methods are inconclusive.