RESUMO
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.
Assuntos
Doença da Artéria Coronariana/diagnóstico por imagem , Imagem de Perfusão do Miocárdio/métodos , Angiografia Coronária , Doença da Artéria Coronariana/diagnóstico , Ecocardiografia sob Estresse , Teste de Esforço , HumanosRESUMO
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.
Assuntos
Encéfalo/diagnóstico por imagem , Demência/diagnóstico por imagem , Tomografia Computadorizada de Emissão de Fóton Único , Idoso , Transtornos Cerebrovasculares/diagnóstico por imagem , Contraindicações , Diagnóstico Diferencial , Epilepsia/diagnóstico por imagem , Humanos , Masculino , Educação de Pacientes como Assunto , Doses de RadiaçãoRESUMO
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.
Assuntos
Doenças da Glândula Tireoide/diagnóstico por imagem , Glândula Tireoide/diagnóstico por imagem , Antitireóideos/uso terapêutico , Feminino , Humanos , Pessoa de Meia-Idade , Guias de Prática Clínica como Assunto , Doses de Radiação , Cintilografia , Compostos Radiofarmacêuticos/uso terapêutico , Pertecnetato Tc 99m de Sódio , Doenças da Glândula Tireoide/tratamento farmacológico , Testes de Função Tireóidea , UltrassonografiaRESUMO
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.
Assuntos
Doenças Ósseas/diagnóstico por imagem , Osso e Ossos/diagnóstico por imagem , Cintilografia/métodos , Adulto , Idoso , Contraindicações , Diagnóstico Diferencial , Fraturas Ósseas/diagnóstico por imagem , Humanos , Masculino , Osteíte Deformante/diagnóstico por imagem , Osso Escafoide/diagnóstico por imagem , Osso Escafoide/lesõesRESUMO
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.
