Early Detection of Myocardial Damages for Patients with Chest Pain and Non-Diagnostic ECG in Emergency Department by Rest Myocardial Perfusion Imaging: A Preliminary Study

Background: According to the World Health Organization (WHO), cardiovascular disease is the significant leading cause of mortality in adults. Some studies demonstrated that rest Myocardial Perfusion Imaging (rMPI) is a reliable test for ruling out myocardial ischemia/infarction in patients with inconclusive diagnostic data including non-diagnostic or normal Electrocardiogram (ECG) and troponin test result. Methods: Patients who presented to the emergency department with chest pain underwent evaluation assay including inquiry about history, having abnormal ECG, troponin test result and physical examination. The patients with normal or non-diagnostic ECG and normal troponin were enrolled in our study. Then, they were referred to the department of nuclear medicine for rMPI. The patients with abnormal rMPI were asked to perform coronary angiography and the patients with normal rMPI were followed up for average of 12.8 months. Results: In this study, 20 patients with mean age of 46.15±12.7 including 7 males and 13 felames were enrolled. Among 20 patients, 14 (70%) patients had normal rMPI and 6 (30%) were abnormal. All patients with abnormal rMPI showed coronary disorders in angiography. Rest of them with normal rMPI were followed up and no cases with cardiac events were found among them. Sensitivity, specificity, positive and negative predictive value for MPI was 100%. Conclusion: According to the data of this study, MPI has a good sensitivity and specificity for diagnosis of myocardial ischemia/infraction and the acute coronary syndrome that prevents unnesseray hospitalization. So, it can be included in the diagnostic protocol in emergency departments of developing countries.