Myocardial perfusion study with 99mTc-sestamibi at rest and after nitrates.
Teaching points:
Myocardial viability studies are important in patients with heart failure and coronary heart disease in order to identify patients in whom either CABG or PTCA could result in functional recovery.
Hibernated (viable) myocardium is thought to be the result of chronic ischemia and is generally associated with improvement after revascularization.
Myocardial viability can be assessed with SPECT perfusion studies (alone or with nitrate stimulation), PET, dobutamine echocardiography, or magnetic resonance imaging, with comparable diagnostic yield.