Nuclear Medicine - Helping to get to the Heart of the Matter
CT coronary angiography is a new diagnostic modality which enables assessment of coronary arteries without invasive catheterization. Diseased vessels are being identified with greater ease but their functional significance is often questionable. Nuclear Medicine assessment is now being undertaken to evaluate the findings detected with this new technique.
Case 1: A 52 year old male with risk factors for coronary artery disease had one episode of chest pain following a large meal and was referred for CT coronary angiography. A tight proximal LAD lesion was identified. An exercise sestamibi study showed ischaemia in the antero-septal and apical segments. The patient was subsequently referred for further management with coronary artery stenting.
Case 2: A 55 year old male with risk factors for coronary artery disease but no chest pain was referred for CT angiography. A diseased right coronary artery with two lesions was identified. An exercise sestamibi study was normal. The patient was managed medically and his risk factors addressed.
The new diagnostic modality of CT coronary angiography is identifying diseased coronary arteries with greater ease. Functional assessment of the lesions is often still required, as illustrated by these cases, before further management can be decided.