Presentation
Cardiac adenosine nuclear stress test performed for left bundle branch block and heart failure. Myocardial risk stratification.
Patient Data
Adenosine stress test
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.
ECG findings
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.