Why not apply more Nuclear Medicine in Cardiology?

Written by: Dr. José Manuel Novoa Crespo
Edited by: Anna Raventós Rodríguez

Nuclear medicine is a technique image used for several decades ago in brain diseases (such as in cognitive impairment), bone, thyroid and, of course, heart. much is also used in oncology (SLNB in ​​breast cancer) and, combined with CT (PET-CT) in the study of multiple tumors.

The technique involves the use of radioisotopes completely harmless (since they have minimal dose of radioactivity) that are injected into the blood and are fixed in a particular organ. By using a device called a gamma camera, get some pictures (scans) of these organs that allow us to study whether they have any alteration in their anatomy or function.

Applications of Nuclear Medicine in Cardiology

In the Cardiology, the main application of Nuclear Medicine is the evaluation of blood flow to the heart in order to detect lesions of the coronary arteries that can cause heart attacks or be angina pectoris. For this, a normal stress test is performed, the isotope is injected before finishing it and then scans are performed, allowing us to see how blood circulated by the heart (ERGOMETRY MIBI-SPECT).

Usually, for detecting ischemic heart disease test it is performed conventional stress. Which is performed with isotopes it has some advantages over it:

  • Has higher sensitivity and specificity (it is more exact), detecting or ruling out disease in 90% of cases.
  • View the irrigation of the heart in the event that the patient 's ECG interpreting prevent normal stress test presented abnormal.
  • Clarifies situations where the normal stress test is doubtful.
  • In the event that the patient has several coronary arteries, lets see which of them is producing more blood flow disturbance, ie, what is the most dangerous.
  • Through the gated SPECT technique, used in our service, you can also see the functioning of the heart before and after exercise.
  • It provides fairly accurate information about the -good or bad prognosis of patients with known coronary lesions and facilitating the indication and choice of treatment.
  • Detects the existence of still living heart cells after a heart attack (Myocardial Viabililidad Study) indicate when a dilation of coronary artery (angioplasty) or surgery (CABG).

On the other hand, it has no disadvantage on the exercise stress test, since the dangers and complications are the same.

Another also very important application is being able to conduct the study in people who for some reason or another can not walk on the treadmill and, therefore, can not make a normal stress test (mobility problems in the legs, elderly, etc.). In these cases a drug (dipyridamole or adenosine) that replaces the effort and later scans (MIBI MIBI-dipyridamole or adenosine) are made, obtaining the same information is injected.

The Nuclear Medicine techniques are also used in cardiology for heart function (radionuclide ventriculography) in patients with cardiomyopathies, valvular lesions or treated with chemotherapy which can be cardiotoxic, as well as some congenital heart defects, which can be calculated the amount of blood passing through a short circuit (shunt) and indicate surgery.

The reason why these imaging techniques are we as well known as other (CT, ultrasound, MRI) is the lack of services Nuclear Medicine at many hospitals, so obviously the cardiologist can not indicate them and have to use other yes techniques at its disposal (Echocardiography stress or strain), equally effective.

In short, the techniques used by the so - called Nuclear Cardiology provide high accuracy in the diagnosis and prognosis, to assess both in operation and blood flow to the heart and are completely harmless




*Translated with Google translator. We apologize for any imperfection

By Dr. José Manuel Novoa Crespo

Dr. Novoa Crespo is a leading specialist in general cardiology, coronary heart disease and sporting checks. He is an expert on nuclear stress test (stress test MIBI-SPECT).

The doctor is part of the Ruber International Hospital in Madrid and the University Hospital Sanitas La Moraleja team. He is head of Cardiology Clinic ICE Madrid, and lecturer at the University Francisco de Vitoria.

*Translated with Google translator. We apologize for any imperfection

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