TID and atrial fibrillation Pre-op evaluation

Case presentation:

• Female.
• 75 y.o.
• Hypertension, moderate overweight, dyslipidemia.
• Asymptomatic, pre-op evaluation (gynecological).
• Medication: ACEI, B-blockers.
• ECG: Atrial fibrillation (AF), average HR 80 bpm, otherwise normal.
• Echo: LVEF 48%, no WMA. - Referred for MPS w/ pharmacologic stress.
• Dipyridamole + rest (2-day protocol); no symptoms, no ECG changes other than previously known AF, BP 135/80 mmHg.

 Teaching points:

• QC data is important info when interpreting gated perfusion studies.
• AF and other arrhythmias can cause false EF values.
• Before considering TID, look at HR during acquisition.
• Changes above 10 bpm between acquisitions can cause difference in LV volume calculation.