Cardiology for the primary care Physician by Joseph S. Alpert (auth.), Joseph S. Alpert MD (eds.)

By Joseph S. Alpert (auth.), Joseph S. Alpert MD (eds.)

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FDG is a marker of regional exogenous glucose uptake. Areas that have reduced perfusion but normal or increased glucose uptake indicate viable tissue. Because of the limited availability of cyclotrons for production of tracers and the cost of PET equipment, it is unlikely that PET scanning will become a widespread and standard technique for the evaluation of CAD. However, it is now feasible to image FDG with a modified SPECT camera, making metabolic imaging more available for clinical use [22].

The presence of late potentials in the terminal portion of the QRS conveys an increased risk of sudden death. Another measure of increased risk is loss of heart rate variability (HRV). HRV 0 TAIIII II INIJI( AIION' IOI( I IMN\! "AI'IIY FI RE 6 olor now 0 ppl r imag from a transesophageal h ardiogram. The ima e r veals a normal I ft ventri I ,a large I ft atrium, and a singl broad turbulent j t of mitral regurgitation ext nding far ba k into th left atrium during ystole. l for po iblc di~c "ti n, atheroma, or aneulJ"m IN I

  • Stress Echocardiography Stress echocardiography is a recently developed modality, permitting the assessment of coronary artery disease by means of regional wall-motion analysis [27]. Despite its potential advantages regarding cost and time efficiency, stress echocardiography has significant limitations: up to 30% of patients do not have adequate acoustic windows, and image interpretation is highly observer dependent. Exercise echocardiography has a sensitivity and specificity similar to that of nuclear stress testing, with a concordance between the techniques of approximately 82% [28].

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