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          Previous MI with no intervention

          Teaching Case

          Case presentation:

          • Female.
          • 68 y.o.
          • Recent acute MI (3 weeks) with no intervention.
          • Discharged with medical treatment.
          • Shortness of breath and chest discomfort.
          • ECG: Atrial fibrillation, complete arrhythmia, Q in V3-V5.
          • The patient underwent a stress/rest myocardial SPECT study with 99mTc-MIBI and dipyridamole.

          Teaching points:

          • Non-invasive functional imaging is indicated after AMI for risk stratification and treatment guidance.
          • Inducible ischemia, depressed LVEF and arrhythmias are key prognostic factors and should be addressed promptly in order to decrease the risk for future cardiac events.
          • Complete arrhythmias (especially due to atrial fibrillation) can interfere with gated acquisition, difficulting the evaluation of LVEF and wall motion.

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