Clinical Presentation

A 56-year-old woman is referred for the evaluation of atypical chest pain. There is no known prior cardiac history. Risk factors include hypercholesterolemia and postmenopausal status. Medications are aspirin and simvastatin.

Fig. 34.1

Technique

• The patient had nothing to eat within 4 hours of the test.

• Rest images were acquired 40 minutes after the intravenous injection of 10 mCi of ^99mTc-sestamibi. Images were acquired in the supine position with a two-headed gamma camera with step-and-shoot rotation, 32 projections over a 90-degree arc for each head (64 projections over a 180-degree arc), 30 seconds per projection, and a 64 × 64 matrix.

• Exercise: 10 minutes, 40 seconds on a Bruce protocol (12.8 METs [metabolic workloads]).