Nuclear Cardiology: A Promise for Improved Cardiovascular Diagnosis:  Will It Be Fulfilled?

Myocardial imaging with radioisotopes is finding increasing clinical application.^1,2 Community hospitals in many areas of the United States have already begun or are now considering application of these new diagnostic techniques to routine clinical practice. The three techniques that have found widest acceptance are (1) infarct avid imaging with technetium Tc 99m pyrophosphate; (2) myocardial imaging with thallous chloride TL 201 to detect myocardial ischemia and infarction; and (3) cardiac blood pool imaging with technetium Tc 99m aggregated albumin or RBCs to evaluate ventricular function. Other techniques such as platelet imaging to detect coronary thrombosis and techniques to detect acute bacterial endocarditis are still undergoing clinical investigations.

Infarct avid imaging with technetium Tc 99m pyrophosphate has been shown to be a highly sensitive technique to detect acute myocardial infarction, if imaging is performed at the optimum time of 48 to 72 hours after onset of symptoms.³ However, utility