ABSTRACT
Different methods for detecting myocardial ischemia and risk assessment like exercise treadmill test and single photon emission computed tomography [SPECT]; however coronary angiography remains the golden standard for defining coronary anatomy. The study aims to compare between Exercise ECO and Thallium scintigraphy in diagnosing and locating coronary artery disease CAD in relation to the gold standard coronary angiography. This study included 40 patients with chronic stable angina with or without past history of acute coronary episodes[20 males and 20 females]. Patients with heart failure, left bundle branch block and/or left ventricular hypertrophy with strain pattern in ECG were excluded from the study. All patientso were submitted to [1] Full history taking and careful clinical examinations. [II] Resting standard 12 lead electrocardiograms [III] Exercise Electrocardiography according to standard Bruce protocol. [IV] Thallium- 201 SPECT study was done according to stress reinjection redistribution protocol. [V] Coronary arteriography was done within two months from stress. We found that exercise stress scintigraphy can detect ischemia or scar [defect] in the territory of LAD with 95% sensitivity, 78% specificity and 93% overall predictive accuracy, while the ability of exercise ECG in localizing anteroseptal ischemia [V2, V3, V4] reached a sensitivity of 32%, specificity of 55% and overall predictive accuracy of 37%. Exercise stress scintigraphy can detect ischemia or scar [defect] in the territory of left circumflex with 75% sensitivity, 78%specificity and 77%overall predictive accuracy. While the ability of exercise ECG in localizing lateral ischemia [LI, aVL, V5, V6], reached a sensitivity of 75%, specificity of 46% and overall predictive accuracy of 53%. Also we found that exercise stress scintigraphy can detect ischemia or scar [defect] in the territory of right coronary artery with 95% sensitivity, 100%speciflcity and 98% overall predictive accuracy. While the ability of exercise ECG in localizing inferior ischemia [LII, LIII, AVF] reached a sensitivity of 47%, specificity of 47% and overall predictive accuracy of 48%