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Journal of Nuclear Cardiology

, Volume 25, Issue 6, pp 2182–2185 | Cite as

Abnormal myocardial perfusion pattern in the absence of significant coronary artery stenosis

  • T. Sean DunnII
  • Jack Heo
  • Ami E. Iskandrian
  • Fadi G. Hage
Images that Teach

Most patients with significant obstruction in the coronary arteries have perfusion abnormalities (reversible, fixed or both) on stress and rest myocardial perfusion imaging (MPI). The presence of such defects (barring those due to attenuation artifacts or misinterpretation) in the absence of angiographically visible “significant” stenosis are usually considered as false-positives.

There are, however, few causes for abnormal perfusion that should be considered before a verdict of false-positive is made. The list (Table  1) does not include “insignificant” stenosis, because the discordance between anatomic stenosis and functional stenosis is now well accepted. 1, 2 The impetus behind this report is a less-known entity that we refer to as diminutive left anterior descending artery (LAD). 3
Table 1

Abnormal myocardial perfusion pattern in the absence of significant coronary artery stenosis

1. Coronary arteries

 a. Anomalous origin

 b. Myocardial bridging

 c. Exercise-induced spasm

 d....

Notes

Disclosure

None to disclose.

References

  1. 1.
    Iskandrian AE, Garcia EV, editors. Nuclear cardiac imaging principles and applications. 5th ed. New York: Oxford University Press; 2015.Google Scholar
  2. 2.
    Iskandrian AE, Garcia EV, editors. Atlas of nuclear cardiology. Imaging companion to Braunwald’s heart disease. Philadelphia: Elsevier/Sunders; 2012.Google Scholar
  3. 3.
    Iskandrian AS, Segal BL. Structure and function of the coronary arteries: How are they related? Cathet Cardiovasc Diagn 1979;5:101-5.CrossRefGoogle Scholar
  4. 4.
    Amabile N, Fraisse A, Quilici J. Hypoplastic coronary artery disease: Report of one case. Heart 2005;91:e12.CrossRefGoogle Scholar

Copyright information

© American Society of Nuclear Cardiology 2018

Authors and Affiliations

  • T. Sean DunnII
    • 1
  • Jack Heo
    • 1
  • Ami E. Iskandrian
    • 1
  • Fadi G. Hage
    • 1
    • 2
  1. 1.Division of Cardiovascular Disease, Department of MedicineUniversity of Alabama at BirminghamBirminghamUSA
  2. 2.Section of CardiologyBirmingham Veterans Affairs Medical CenterBirminghamUSA

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