Eight days after undergoing a hysterectomy, a 64-year-old woman complains of chest pain. After 12 hours, the internist orders tests to exclude MI. Which test will most likely support this diagnosis?
Correct Answer: Tc 99m pyrophosphate scintigraphy showing a "hot spot"
Description: 99mTc pyrophosphate scintigraphy showing a "hot spot". Following injection of 99mTc pyrophosphate, scintigraphy may show a hot spot in the infarcted area. The hot spot is developed as the radiotracer forms a complex with calcium in necrotic tissue. The test should be requested within the first 18 hours following the onset of acute MI. It is not sensitive enough to detect small infarctions. Following 201Tl scintigraphy, a "cold spot" occurs because of hypoperfusion. The test is performed where exercise or dipyridamole (Persantine) injection can be given. SGOT levels are elevated in liver disease. The HIDA scan is used to exclude gallbladder disease. Cardiac enzyme levels and ECG findings are useful to establish a diagnosis of MI.
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