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Stress Thallium-201 Myocardial Scintigraphy in Patients With Complete Occlusion of the Left Main Coronary Artery*

Takashi Hatori, MD; Takuji Toyama, MD; Tomoyuki Yokoyama, MD; Masashi Arai, MD; Masahiko Kurabayashi, MD; Tsugiyasu Kanda, MD; Shigeru Oshima, MD
Author and Funding Information

*From the Second Department of Internal Medicine (Drs. Hatori, Toyama, Yokoyama, Arai, and Kurabayashi) and the Department of General Medicine (Dr. Kanda), Gunma University School of Medicine, Gunma, Japan; and the Department of Cardiovascular Medicine (Dr. Oshima), Gunma Prefectural Cardiovascular Center, Maebashi, Gunma, Japan.

Correspondence to: Takuji Toyama, MD, Second Department of Internal Medicine, Gunma University School of Medicine, 3–39-15 Showa-Machi, Maebashi, Gunma 371-0034, Japan; e-mail: toyama@ca.mbn.or.jp



Chest. 2001;120(4):1409-1412. doi:10.1378/chest.120.4.1409
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Complete occlusion (CO) of the left main coronary artery (LMCA) is a rare but often fatal condition. The diagnosis is frequently missed because the signs and symptoms are often obscure and diverse. We describe three patients with CO-LMCA who showed unusual myocardial scintigraphic findings. The patients had extensive right-to-left collateral channels and decreased uptake and washout rates at the basal anterior and anterolateral portions of the heart wall during stress thallium-201 scintigraphy. The basal anterior to anterolateral portion of the heart wall is the most distant from the collateral artery and should be the most ischemic area shown during exercise, resulting in this scintigraphic pattern. This scintigraphic finding may be useful for the noninvasive diagnosis of CO-LMCA.

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