MCQ : Nuclear-26
38 year old female with syncope.
- No prior medical history
- Rest ECG is shows NSR, complete heart block with junctional escape rhythm
- On No medications
- Normal echocardiogram and Lab work
What is the best interpretation based on this image?
A) LAD territory infarct and no hibernation
B) LAD territory infarct and ischemia
C) Basal septal and anterior wall perfusion defect with inflammation
D) Non diagnostic test due to poor dietary preparation
Rest Rb PET and Metabolic FDG
Correct Answer is C) : Focal inflammation in the basal septum/basal anterior wall
- Perfusion defect at basal segments (not typical for CAD)
- Matching FDG uptake in the areas of perfusion defects consistent with active inflammation.
- Good suppression of FDG uptake in normal myocardium indicating good dietary preparation (18 hour fasting and no carbohydrates for 24 hours)
- The location of the abnormalities support an inflammatory etiology for complete heart block
