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Human Health Campus
Human Health Campus
Human Health Campus

Heart failure post-MI Myocardial viability with nitrates

Teaching Case

Case presentation:

  • Male.
  • 73 y.o.
  • Previous myocardial infarction, heart failure.
  • Submitted for myocardial viability assessment.
  • 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.

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