Ischemic Heart Disease

You can learn the role of cardiac imaging in stable CAD. A Multimodality Imaging lesson.

You can learn: what viable myocardium is, what hibernating myocardium is, how they can be detected, evidence for the benefit of revascularisation

To learn the role of cardiac CT in the evaluation of coronary stents and coronary artery by-pass grafts: from diagnosis to prognosis.

1. A balanced view and experience from the Principal investigator of the imaging CoreLab for the much anticipated ISCHEMIA trial. 2. Lessons on how this trail learned from the past and will influence our future practice. 3. What groups benefit from ischemia evaluation?

A step-by-step guide on how you can perform the fusion of CCTA with SPECT images.

Challenges with prior CABG 1. Anatomic “landmarks” of various coronary arteries are not applicable 2. Segmental defects that are not contiguous 3. ECG changes that are not specific for ischemia 4. Abnormal septal motion 5. Flows and flow reserves are not well validated 6 Correlation with angiographic results may be challenging

Classic echocardiographic images of septal rupture, pseudoaneurysms, acute mitral regurgitation Chart Flow for management of patients in carcinogenic shock due to mechanical complications of MI.

Avoid the occulo-stenotic reflex. Review other imaging data if available. Severely fixed defects can be scar or hibernation. Unwise to open a coronary vessel to dead myocardium. Differentiate between LAD and diagonal/ramus.

TID, does it always represent ischemia or pathology? Understanding how perfusion and gated images are acquired.

A brief description of a positive MPS in the LCx territory in a patient with mitral regurgitation.

Compare and contrast the value and images of PET and SPECT-CT in the setting of LBBB.

Identify the “fingerprints” of scarred myocardium on a cardiac PET in contrast to ischemic or hibernating myocardium.

This tutorial will walk you step by step through an abnormal MPS CZT study.

Explain why we assess for hibernating myocardium, instances when assessment for hibernating myocardium is not indicated, and finally patient preparation and mini-tutorial on image display and reporting of findings.

We will guide you on the process we use for reading cardiac perfusion and metabolic PETs to evaluate myocardial hibernation. This process will allow you to identify myocardium at risk even when rest and stress perfusion images show a fixed perfusion defect.

Describing PET findings of “ischemia” and correlating the finding with unusual LV morphology.

Step by step review of identifying ischemia on cardiac PET and recognizing high risk markers.

This tutorial will walk you step by step through an abnormal PET study and help you identify high risk markers.

Identify areas of ischemia, correlate the ischemia to a coronary/ies territory, recognize TID and assign the scan a risk score.

  • These tutorials are used for educational purposes and not to direct individual patient care.
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