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Right ventricular ischemia in patients with primary pulmonary hypertension

Arturo Gómez, MD^*, David Bialostozky, MD, Alan Zajarias, MD^*, Efrén Santos, MD^*, Andrés Palomar, MD^*, María Luisa Martínez, MD^* and Julio Sandoval, MD^*

^* Cardiopulmonary Department of the Instituto Nacional de Cardiología "Ignacio Chávez," Mexico City, Mexico
Department of Nuclear Cardiology of the Instituto Nacional de Cardiología "Ignacio Chávez," Mexico City, Mexico

View larger version (14K): [in a new window]   Figure 1 (A) Schematic representation of the heart in short axis. (B) Images were processed by manual delineation of the right ventricle (RV) and masking of the left ventricle (LV). (C) The RV walls were defined as anterior, lateral and inferior and subsequently analyzed.

View larger version (71K): [in a new window]   Figure 2 (A) Short-axis projection of a myocardial single photon emission computed tomography (SPECT) with 99mTc-sestamibi, where right ventricular (RV) wall hypertrophy and cavity dilation that increases after stress are evident. The left ventricle (LV) is shown without perfusion defects. (B) Myocardial SPECT with 99mTc sestamibi processed to mask the LV enhances RV visualization where there are no evident perfusion defects. (C) Short-axis projection of a myocardial SPECT with 99mTc sestamibi corresponding to D. (D) Myocardial SPECT with 99mTc sestamibi processed to enhance RV visualization, where perfusion defects are evident in the basal third of the inferior and lateral walls of the RV in the stress images only (arrows). There is marked dilation and hypertrophy of the RV walls.