A Case of Variant Angina Pectoris With Similar Findings on Both Rest and Matched Exercise Thallium-201 Studies

概要

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A patient with variant angina showed similar findings on both the rest and matched exercise ^<201>Thallium(^<201>Tl)myocardial perfusion scintigrams. The 65-year old man was admitted to hospital because of rest angina. His electrocardiogram during the attack disclosed ST segment elevation on inferior leads. However, emergency coronary arteriogram showed no fixed stenosis. Intracoronary injection of acetylcholine induced a spasm on the distal right coronary artery, but not in the left coronary artery. In the rest ^<201>Tl study, septal perfusion was low on the early image, although partial redistribution of this site was observed on the delayed image without the appearance of chest pain or electrocardiographic ischemic change. Similary, in the ^<201>Tl exercise study undergone 2 weeks later, septal redistribution was diagnosed because the early image had decreased septal perfusion. Both the exercise ^<123>I-metaiodobenzylguanidine study and the rest 123I-betamethyl-p-iodophenyl-pentadecanoic acid study showed inferior abnormalities on the early and delayed images. Althouth a coronary spasm was not induced in the left anterior descending artery with the acetylcholine test, septal redistribution was observed on the delayed image of both the rest and exercise ^<201>Tl studies. The mechanism of the redistribution on the rest ^<201>Tl study was nuclear.
社団法人日本循環器学会の論文
1998-09-20