ABSTRACT
Coronary artery disease (CAD) remains a major health concern and the leading cause of death in Australia. Effective assessment of patients for possible CAD is a common problem in general practice. Non-invasive tests such as myocardial perfusion scans (MPS), exercise stress tests (ESTs) and stress echocardiography (using exercise or dobutamine as the stressor, as appropriate) can provide useful diagnostic and prognostic information. This brief review discusses the role of MPS in the evaluation of CAD.
Subject(s)
Coronary Artery Disease/diagnostic imaging , Myocardial Perfusion Imaging/methods , Coronary Angiography , Coronary Artery Disease/diagnosis , Echocardiography, Stress , Exercise Test , HumansABSTRACT
This article forms part of our 'Tests and results' series for 2013, which aims to provide information about common tests that general practitioners order regularly. It considers areas such as indications, what to tell the patient, what the test can and cannot tell you, and interpretation of the results.
Subject(s)
Brain/diagnostic imaging , Dementia/diagnostic imaging , Tomography, Emission-Computed, Single-Photon , Aged , Cerebrovascular Disorders/diagnostic imaging , Contraindications , Diagnosis, Differential , Epilepsy/diagnostic imaging , Humans , Male , Patient Education as Topic , Radiation DosageABSTRACT
This article forms part of our 'Tests and results' series for 2012, which aims to provide information about common tests that general practitioners order regularly. It considers areas such as indications, what to tell the patient, what the test can and cannot tell you and interpretation of results.
Subject(s)
Thyroid Diseases/diagnostic imaging , Thyroid Gland/diagnostic imaging , Antithyroid Agents/therapeutic use , Female , Humans , Middle Aged , Practice Guidelines as Topic , Radiation Dosage , Radionuclide Imaging , Radiopharmaceuticals/therapeutic use , Sodium Pertechnetate Tc 99m , Thyroid Diseases/drug therapy , Thyroid Function Tests , UltrasonographyABSTRACT
This article forms part of our 'Tests and results' series for 2012, which aims to provide information about common tests that general practitioners order regularly. It considers areas such as indications, what to tell the patient, what the test can and cannot tell you and interpretation of results.
Subject(s)
Bone Diseases/diagnostic imaging , Bone and Bones/diagnostic imaging , Radionuclide Imaging/methods , Adult , Aged , Contraindications , Diagnosis, Differential , Fractures, Bone/diagnostic imaging , Humans , Male , Osteitis Deformans/diagnostic imaging , Scaphoid Bone/diagnostic imaging , Scaphoid Bone/injuriesABSTRACT
OBJECTIVES: This prospective study investigated the effects of caffeine ingestion on the extent of adenosine-induced perfusion abnormalities during myocardial perfusion imaging (MPI). METHODS: Thirty patients with inducible perfusion abnormalities on standard (caffeineabstinent) adenosine MPI underwent repeat testing with supplementary coffee intake. Baseline and test MPIs were assessed for stress percent defect, rest percent defect, and percent defect reversibility. Plasma levels of caffeine and metabolites were assessed on both occasions and correlated with MPI findings. RESULTS: Despite significant increases in caffeine [mean difference 3,106 µg/L (95% CI 2,460 to 3,752 µg/L; P < .001)] and metabolite concentrations over a wide range, there was no statistically significant change in stress percent defect and percent defect reversibility between the baseline and test scans. The increase in caffeine concentration between the baseline and the test phases did not affect percent defect reversibility (average change -0.003 for every 100 µg/L increase; 95% CI -0.17 to 0.16; P = .97). CONCLUSION: There was no significant relationship between the extent of adenosine-induced coronary flow heterogeneity and the serum concentration of caffeine or its principal metabolites. Hence, the stringent requirements for prolonged abstinence from caffeine before adenosine MPI - based on limited studies - appear ill-founded.
