The document presents an overview of nuclear cardiology, emphasizing its role in assessing coronary heart disease and future heart attack risks through procedures like MUGA and MPI. It details case studies, patient preparation, testing protocols, and the efficacy of angioplasty and stenting in restoring blood flow to ischemic myocardium. The conclusion highlights the positive outcomes of intervention treatments in improving heart function.

1. Nuclear Cardiologydepartment – PrinceSultanCardiac Centre
This Presentation Presented by : BudourAlzahrani
Supervised : MohamedAlshuhri ,SaeedAlshuhri
Acknowledgment to : Dr.AhmedAmro

2. Outlines
Introduction
Nuclear
Cardiology
Case review
Result
Conclusion
and References

3. Introduction
coronary heartNuclear cardiac images help to identify
disease, and the risk of future heart attacks.
These highly
function and
accurate measurements of heart size and
amount of heart muscle at risk enable
cardiologists to better prescribe medications and select further
testing.

4. Nuclear Cardiology
-2-
In nuclear medicine there are many procedures to evaluate cardiac
function , the most common are :
1 MUGA ( Multi Gated) Scan
-1-
2 MPI (Myocardial Perfusion Imaging)

5. MPI– overview
During a nuclear cardiology test, a very small amount of
radioactive tracer injected into a vein and is taken up by the
heart.
A very sensitive gamma camera takes images
of the heart in the rest and stress part.

6. Who needs MPI
-Detection of myocardial infarction or ischemia.
-Patients who undergo for kidney transplant.
-Assessment of myocardial viability.
-Chest pain, shortness of breath, family history of
heart disease.

7. How MPIis performed
MPI divided into 2 parts ( Stress – Rest ).
We can perform it in one day , or 2 day depending on
patient weight.

8. Patient info
43 yo, male
co  SOB
Echo  EF= 55%
Case study

9. Patient Preparation
study time.
-Patient should be NPO for 6 hours.
-if stress: Caffeine is forbidden 24hrs before
(coffee, tea, smoking…etc).
-hold all heart medications until end the test.

10. Rest StudyInjection
one day procedure, with 300Mbq of Tc99m
Tetrofosmin.
IV injection with flush , why flush?
After the tracer is injected, the patient
should wait 45-60 mins after injection then,
we can start scanning.

11. Stress Study
Treadmill 
be maximum “depending onHeart rate should
patient's age“
Max. HR. = (220 – age) , then x 80%
before stop the
This case 90% of max. HR.
Injection 800Mbq, 1-2 minutes
treadmill.
ECG
monitoring

12. mins after
If : Pharmacologically
Position patient supine. ECG monitoring in both procedures.
Both Pharmacological and exercise , scan begin 15-30
injection.
Stress Study

13. Pharmacological
Persantine : inject 0.56/kg over 4 minutes. Wait 2 minutes more, then inject
and flush the radiopharmaceutical dose.
Antidote: Aminophylline, when?
Adenosine : Infuse drug for 6 minutes. Inject at 3 or 4 minutes.
Antidote: Aminophylline.
Dobutamine : Used if there are known allergies, asthma, or pulmonary disease.

14. Scan
-Patient position : Supine with , (thearm up
and three-leadarm may create an artifact),
ECG.
-The camera will rotate around chest.
producegamma
detects
camera does not
photons and produce raw
radiation; it
data of the
patient's heart.
Takes approximately 7 mins.
Stress & Rest Study

15. images

16. The first MPI on 26-AUG 2015

18. What you know about ischemia
• condition in which the blood flow is reduced in
tissue or a part of the body.

19. Medical Management
After the nuclear scan the doctor sent the patient to the
Cath Lab 27th of AUG2015
LAD, Diagonal (branch): totally occluded.
2wire, dilated, kissing balloons + stent of diagonal.
Result:
Diagonal look big, with good result.
He came back after 5months to nuclear cardiology for follow up.

20. images

21. The second MPI on 27-1-2016

23. 27-1-201626-8-2015

24. 26-8-2015 27-1-2016

25. Conclusion
Angioplasty and stenting have a good result in improve and
increase blood flow to the ischemic myocardium.
And it may become normal tissue after treatment.

26. References
• PSCC
• Urmc.rochester.edu,. (2016). Nuclear Cardiology Tests - Department of
Cardiology - Rochester, NY - University of Rochester Medical Center . Retrieved
1 March 2016, from https://www.urmc.rochester.edu/cardiology/patient-
care/diagnostic-tests/nuclear-cardiology.aspx
• Heart.org

27. Thanksfor listening