REVERSE REDISTRIBUTION ON DYNAMIC EXERCISE AND DIPYRIDAMOLE STRESS TECHNETIUM-99M-MIBI MYOCARDIAL SPECT

Reverse redistribution on (TI)-T-201-chloride stress-redistribution my ocardial scintigraphy has been associated with coronary artery stenosi s. We report a patient whose two separate Tc-99m-MIBI myocardial SPECT stress studies (dynamic exercise and dipyridamole) showed septal reve rse redistribution and fixed inferior defect. Echocardiograms showed l eft ventricular (LV) hypertrophy and diffuse hypokinesis, especially i n the inferior wall, and EKG showed LV hypertrophy and strain and infe rior infarct. Coronary angiogram confirmed two-vessel disease involvin g 80%-90% stenosis of the proximal second diagonal branch of the left anterior descending artery and 75%-90% stenosis of the right coronary artery as well as global left ventricular dysfunction. Reverse redistr ibution on (TC)-T-99m-MIBI myocardial SPECT occurring on dynamic or di pyridamole stress may indicate damaged but viable myocardium.