Author + information
- Received November 19, 1993
- Revision received January 27, 1994
- Accepted February 2, 1994
- Published online July 1, 1994.
- ↵∗Address for correspondence: Dr. D. Douglas Miller, Associate Professor of Medicine, Division of Cardiology, Saint Louis University Medical Center. 3635 Vista Avenue at Grand Boulevard, P.O. Box 15250, St. Louis, Missouri 63110-0250.
Controversy exists with regard to the diagnostic accuracy and optimal technique of myocardial perfusion imaging after coronary angioplasty. Exercise treadmill testing is inexpensive, with adequate predictive value for restenosis and clinical events in patients with single vessel coronary angioplasty with a normal rest electrocardiogram (ECG). Myocardial tomography has advantages for assessing patients with multivessel coronary angioplasty. Exercise stress imaging is generally preferable to pharmacologic stress in patients without physical limitations after angioplasty. Delayed thallium-201 imaging and reinjection protocols may be useful to reconcile whether residual ischemia exists in “fixed” perfusion defects. Appropriately timed stress myocardial perfusion imaging 2 to 4 weeks after procedurally successful coronary angioplasty can document improved cardiac functional capacity and reduced ECG and imaging evidence of myocardial ischemia. Although routine serial postangioplasty evaluations cannot be recommended, stess myocardial imaging may be valuable in subjects with defective anginal nocioception or extensive myocardium at risk in the area subtended by the angioplasty vessel.
- Received November 19, 1993.
- Revision received January 27, 1994.
- Accepted February 2, 1994.