Acute subendocardial myocardial infarction: Its detection by Tc-99m-stannous pyrophosphate myocardial scintigraphy

J. I. Pulido, R. W. Parkey, S. E. Lewis, L. M. Buja, F. J. Bonte, G. Dehmer, M. J. Stone, J. T. Willerson

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Sixty-two patients hospitalized because of prolonged chest pain and initial electrocardiographic (ECG) changes of ST depression and T-wave inversion suggestive of acute subendocardial myocardial infarction were evaluated to determine the ability of Tc-99m-stannous pyrophosphate myocardial scintigraphy to detect the presence or absence of acute subendocardial myocardial necrosis. Three groups of patients were designated. Group A consisted of eight patients (13%) who developed reduction of R-waves of more than 25% or new Q-waves broader than 0.03 seconds; of these patients with acute transmural myocardial infarction, all had well-localized, abnormal scintigrams. Group B consisted of 30 patients with ECG changes and subsequent enzymatic documentation, including elevated serum creatine kinase-B levels as determined by radioimmunoassay, of the presence of acute subendocardial myocardial infarction. Of these, 27 had abnormal scintigrams, including 18 with well-localized patterns and nine with 'poorly localized' patterns. Group C consisted of 24 patients (39%) with chest pain, but without enzymatic documentation of the presence of acute myocardial infarction (acute coronary insufficiency). Eight of these had abnormal scintigrams, including one with a well-localized pattern and seven with 'poorly localized' patterns. In four of the latter, the scintigrams were 'persistently positive' several weeks to months after a previous myocardial infarct. Serial myocardial imaging will be necessary to identify such patients.

Original languageEnglish (US)
Pages (from-to)191-195
Number of pages5
JournalClinical Nuclear Medicine
Issue number5
StatePublished - Jan 1 1980

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging


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