Special Cases

Left Bundle Branch Block (Case 2)

FINDINGS
IMPRESSION
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Impression:

First impression (first set of images):

  • Reduced uptake in septum at rest. With treadmill stress and the associated increase in heart rate, a notable increase in extent and severity of the septal abnormality is apparent (small lines and bullseye images) -- consistent with ischemia.

    However, in the setting of LBBB the above findings are not diagnostic of CAD. Hence the patient was studied again one week later using iv Persantine resulting in little increase in heart rate.

    Final impression (second set of images):

  • The stress study does not demonstrate changes in the septum. This strongly suggests functional perfusion abnormality in septum secondary to LBBB, and not due to CAD.
  • The stress induced changes in the inferior wall are not diagnostic.
    • MARKED IMAGES (TOP)


    Atlas of Myocardial Perfusion SPECT
    © Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
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    Initiated: Nov 19, 1995. Last updated: April 26, 1999.