Left bundle branch block artifact on cardiac nuclear medicine scan

Case contributed by Dr Jayanth Keshavamurthy

Presentation

Cardiac adenosine nuclear stress test performed for left bundle branch block and heart failure. Myocardial risk stratification.

Patient Data

Age: 75 years
Gender: Male

Adenosine stress test

Nuclear medicine

Wall motion abnormalities of the septum consistent with left bundle branch block (LBBB).

Decreased perfusion of the septum seen on rest and stress images. No reversible stress induced ischemia.

Most likely cause for this finding is LBBB artifact mimicking a septal infarct. Since it is stable from a prior nuclear medicine scan no further workup is ordered.

Signs of LBBB such as widened QRS complexes.

 

Case Discussion

The findings of stress test correlates with the echocardiographic and electrocardiographic findings of LBBB and septal wall motion abnormalities.

If the suspicion for an infarct is very high a cardiac PET-CT can be performed for confirmation.

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