ENTEROGASTRIC BILE REFLUX DURING TECHNETIUM-99M-SESTAMIBI CARDIAC IMAGING

Enterogastric bile reflux (EGBR), a risk factor for both gastritis and esophagitis, is a potentially treatable noncoronary cause for chest p ain. Methods: To investigate the frequency of EGBR during different Tc -99m-sestamibi cardiac imaging, 1405 consecutive Tc-99m-sestamibi SPEC T myocardial perfusion studies were reviewed. Results: One hundred six teen of the 1405 patient studies (8.3%) showed EGBR with roughly equal numbers of patients having marked (43 patients), moderate (38 patient s) or minimal (35 patients) intensity of abnormal gastric activity. Tw o examinations showed gastroesophageal reflux of activity. EGBR was le ss frequent with treadmill stress testing (5.5% patients) than with ph armacologic stress testing using either dipyridamole (11% of patients) or dobutamine (9.2% of patients) (p > 0.005). EGBR also was more freq uent in patients over 40 yr of age. Finally, the prevalence of upper g astrointestinal symptoms and the frequency of established upper gastro intestinal diagnoses correlated strongly with the presence and intensi ty of EGBR, Conclusion: Clarification of the full clinical significanc e of EGBR during Tc-99m-sestamibi cardiac imaging is a topic for futur e research. Nonetheless, the imaging finding of EGBR may, in fact, ide ntify a potentially treatable noncoronary cause for chest pain.