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Nuclear Cardiology: A breakthrough in non-invasive modality

It can show deficit in Myocardiac perfusion and viability of the heart muscle

Dr. GN Mahapatra

Sr. Consultant & Head Dept. of Nuclear Medicine

Seven Hills Hospital, Mumbai

“Nuclear cardiology is an important non-invasive modality, which can help ascertain viability of the heart muscle by measuring the myocardial perfusion deficit. A stress myocardial perfusion can give this important piece of information to the cardiac surgeon performing angioplasty or bypass surgery,” says Dr. GN Mahapatra, Consultant and Head of Nuclear Medicine and PET from Seven Hills Hospital, Mumbai. New innovations in Nuclear Cardiology help plan a treatment by detecting a vulnerable plaque, which can block a major coronary artery. Talking specifically about major advances, Dr. Mahapatra says, “A stress myocardial perfusion scan with a PET perfusion imaging agent is better than the stress thallium myocardial perfusion scan. A gamma camera called D SPECT gamma camera gives the image quality of a myocardial perfusion scan using comparatively lesser radiation.”

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Dr. GN Mahapatra

</b> I am professor DR. GN Mahapatra, Consultant and Head of Nuclear Medicine and PET from Seven Hills Hospital, Mumbai. I am also the founder of Nuclear Cardiological Society of India. Nuclear cardiology is a important subspecialty, non-invasive modality where it can diagnose coronary artery disease, where it can pinpoint how much is the myocardial perfusion deficit as compared to the blockage in the coronary artery, whether that muscle is viable or not viable, we can do the evaluation by doing a stress myocardial perfusion scan and so that we can give this important information to the cardiologist and cardiac surgeon to go ahead with the further treatment planning like coronary angioplasty or bypass surgery. If a viable muscle is there and which we can give this information then the patient would benefit out of angioplasty or CABG surgery. So in today’s my talk, I discussed lot of new innovations in Nuclear Cardiology in 2015 where we can detect the vulnerable plaque from the stable plaque and so that because vulnerable plaque as you know all, it is a very unstable plaque which can go and travel very frequently and block a major coronary artery and produces a huge amount of myocardial infraction or necrosis. So, we have to diagnose the vulnerable plaque, so that the treatment planning or treatment can be started immediately. Similarly, the agent which has come up is called FDG and/or F18 sodium fluoride where it can diagnose. So number two innovation, very important innovation is that where we can do a stress myocardial perfusion scan with a PET perfusion imaging agent that is called ______ which is equal or is better as compared to the stress thallium myocardial perfusion scan. The phase III clinical trial is over and it is going to be soon available. We can do a PET myocardial perfusion imaging agent as we have been doing for the last three decades, the stress thallium myocardial perfusion scan. Similarly, we have got newer dedicated equipment that gamma camera called D SPECT gamma camera where we can do a study for 3-4 minutes and we have to give a lesser dose, so lesser radiation to the patient and image quality is as comparable to the earlier myocardial perfusion scan quality. So there are lot of other advances which are there so with this I end my talk. For the common public, what I would give this message to them that when a person has got diabetes or hypertension or obesity or dyslipidemia, silent diabetic patients or uncontrolled diabetes mellitus, all these patients when they come, then which is the test which they do whether they do echocardiography, or they do a stress thallium Myoview or that they do a coronary angiography which is an invasive procedure. In my opinion, these patients they should come and do a noninvasive myocardial perfusion scan where you can pinpoint the location of the disease, how is the viability, what is in the treatment planning, whether medical or surgical or angioplasty we can be done in those patients. The patients who have already done angioplasty or bypass, they come back and they can do a myocardial perfusion scan where we can rule out any re-stenosis or re-blockage in the coronary arteries. The take home message or a healthy heart which I mean is diet. The patient should be good at controlling the risk factors, for example diabetes, hypertension, hyperlipidemia, obesity and morning, evening walking and a healthy food and these are the things which one must do it and suppose the perform has got risks factors they should see that these risks factors should be under the controllable limit all the time. I do not think that if these things can be done, and definitely there is no test is also required except the small blood test for the risks factors.

  • Blood pressure
  • Diabetes
  • Angiography
  • ACE inhibitors
  • ARBs
  • Beta Blockers

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