Case Author(s): Thomas H. Vreeland,MD /J. Wallis, M.D. , 04/10/94 . Rating: #D2, #Q3
Diagnosis: Prominent (normal) atrial activity
Brief history:
Rule out ischemia prior to ECT therapy.
Images:
Dipyridamole-Thallium: (Rows) Top = Stress; Bottom = Rest
(Columns) 1=septal; 2=anterior; 3=70 degree LAO
View main image(mi) in a separate image viewer
Full history/Diagnosis is available below
Diagnosis: Prominent (normal) atrial activity
Full history:
This patient is an 83 year-old woman with a history of atrial fibrillation,
congestive heart failure, and hypertension, who is being
evaluated to rule out ischemia prior to receiving ECT
treatment for refractory depression.
Findings:
Myocardial Imaging (Dipyridamole/Redistribution-planar only):
1. Normal variant with prominent activity seen in
all four chambers.
2. No evidence of ischemia.
Followup:
Comparison with a chest radiograph confirmed the unusual uptake to
be in the expect region of the artria, which can be seen
as a normal variant. Increased atrial uptake may relate to hypertrophy. The patient has no history of
malignacy, making uptake by mediastinal tumor unlikely.
Major teaching point(s):
Differential Diagnosis List
Differential for Soft tissue uptake of Thallium in the mediastinum is modified from Datz, Frederick L. : Gamuts in Nuclear Medicine, 2nd Edition.(See References):
1. Normal Variant
2. Tumors (benign or malignant)
3. Substernal Thyroid - rare
4. Atrial hypertrophy
ACR Codes and Keywords:
References and General Discussion of Myocardial Imaging (Anatomic field:Heart and Great Vessels, Category:Normal, Technique, Congenital Anomaly)
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Case number: mi001
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