Nuclear Cardiology Case: A 65 year old woman with history of COPD and mild hypertension, now presented with CHF

A 65 year old woman with history of COPD and mild hypertension, now presented with CHF.
SPECT myocardial perfusion studies were performed using Tc-99m-Sestamibi and Dobutamine. Images representing myocardial perfusion were obtained at rest and peak stress.

Stress protocol is Dobutamine
Duration of stress is 7 min 57 sec
Peak heart rate (basal --> peak) is 92 --> 100 (85%=131)
Systolic BP (basal --> peak) is 130 --> 134 --> 92
Double product (peak rate x BP) is 13,400
Reason for termination is Typical chest pain
ECG findings are ST-T abnormality at rest, No additional changes

Echocardiography:
Moderate LV and RV enlargement with moderate-to- severe generalized contractile dysfunction. LVEF=20-30%
Mild mitral regurgitation (2+) without structural valve abnormality Tricuspid regurgitation (2+)

Figure 1

Figure 2: Labelled for easy identification

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