cardiologia nuclear
TRANSCRIPT
![Page 1: Cardiologia Nuclear](https://reader035.vdocuments.mx/reader035/viewer/2022062220/55792f2bd8b42ad6678b46aa/html5/thumbnails/1.jpg)
Cardiología Nuclear
• 1. Perfusión Miocárdica (Isquemia)
• 2. Pirofosfato Cardíaco (Infarto Agudo)
• 3.Ventriculografía (Función)
• 4. Metabolismo (viabilidad)
![Page 2: Cardiologia Nuclear](https://reader035.vdocuments.mx/reader035/viewer/2022062220/55792f2bd8b42ad6678b46aa/html5/thumbnails/2.jpg)
Infarto agudo lateral (PYP)
![Page 3: Cardiologia Nuclear](https://reader035.vdocuments.mx/reader035/viewer/2022062220/55792f2bd8b42ad6678b46aa/html5/thumbnails/3.jpg)
Infarto subendocárdico extenso (99mTcPYP)
![Page 4: Cardiologia Nuclear](https://reader035.vdocuments.mx/reader035/viewer/2022062220/55792f2bd8b42ad6678b46aa/html5/thumbnails/4.jpg)
Infarto agudo ventrículo derecho (PYP)
![Page 5: Cardiologia Nuclear](https://reader035.vdocuments.mx/reader035/viewer/2022062220/55792f2bd8b42ad6678b46aa/html5/thumbnails/5.jpg)
Infarto agudo del miocardiomenos de 6 horas mas de 6 horas
![Page 6: Cardiologia Nuclear](https://reader035.vdocuments.mx/reader035/viewer/2022062220/55792f2bd8b42ad6678b46aa/html5/thumbnails/6.jpg)
Amiloidosis cardíaca
![Page 7: Cardiologia Nuclear](https://reader035.vdocuments.mx/reader035/viewer/2022062220/55792f2bd8b42ad6678b46aa/html5/thumbnails/7.jpg)
Perfusión miocárdica normal
![Page 8: Cardiologia Nuclear](https://reader035.vdocuments.mx/reader035/viewer/2022062220/55792f2bd8b42ad6678b46aa/html5/thumbnails/8.jpg)
![Page 9: Cardiologia Nuclear](https://reader035.vdocuments.mx/reader035/viewer/2022062220/55792f2bd8b42ad6678b46aa/html5/thumbnails/9.jpg)
Prueba de esfuerzo, infradesnivel del ST
![Page 10: Cardiologia Nuclear](https://reader035.vdocuments.mx/reader035/viewer/2022062220/55792f2bd8b42ad6678b46aa/html5/thumbnails/10.jpg)
Perfusión miocárdica en ejercicioRadiofármacos análagos del potasio
talio201
isonitrilos-Tc99m
![Page 11: Cardiologia Nuclear](https://reader035.vdocuments.mx/reader035/viewer/2022062220/55792f2bd8b42ad6678b46aa/html5/thumbnails/11.jpg)
Perfusión miocárdica
• Stress físico • Stress farmacológico
![Page 12: Cardiologia Nuclear](https://reader035.vdocuments.mx/reader035/viewer/2022062220/55792f2bd8b42ad6678b46aa/html5/thumbnails/12.jpg)
Función ventricular normal (Germano)
![Page 13: Cardiologia Nuclear](https://reader035.vdocuments.mx/reader035/viewer/2022062220/55792f2bd8b42ad6678b46aa/html5/thumbnails/13.jpg)
Cardiopatía dilatada, FE 9%
![Page 14: Cardiologia Nuclear](https://reader035.vdocuments.mx/reader035/viewer/2022062220/55792f2bd8b42ad6678b46aa/html5/thumbnails/14.jpg)
Isquemia anteroseptal
![Page 15: Cardiologia Nuclear](https://reader035.vdocuments.mx/reader035/viewer/2022062220/55792f2bd8b42ad6678b46aa/html5/thumbnails/15.jpg)
Hombre de 49 años, dislipidema, infarto 3 meses antes, stent en la primera diagonal, FE 37%, dipiridamol
![Page 16: Cardiologia Nuclear](https://reader035.vdocuments.mx/reader035/viewer/2022062220/55792f2bd8b42ad6678b46aa/html5/thumbnails/16.jpg)
Dilatación transitoria del VI, enfermedad coronaria de tres vasos, hombre de 62 años, valoración prequirúrgica de esofaguectomía, FE 43%
![Page 17: Cardiologia Nuclear](https://reader035.vdocuments.mx/reader035/viewer/2022062220/55792f2bd8b42ad6678b46aa/html5/thumbnails/17.jpg)
Isquemia anteroseptal
![Page 18: Cardiologia Nuclear](https://reader035.vdocuments.mx/reader035/viewer/2022062220/55792f2bd8b42ad6678b46aa/html5/thumbnails/18.jpg)
Segmentos cardíacos
![Page 19: Cardiologia Nuclear](https://reader035.vdocuments.mx/reader035/viewer/2022062220/55792f2bd8b42ad6678b46aa/html5/thumbnails/19.jpg)
Coronariografía perfusión miocárdica(anatomía) (isquemia, función)
![Page 20: Cardiologia Nuclear](https://reader035.vdocuments.mx/reader035/viewer/2022062220/55792f2bd8b42ad6678b46aa/html5/thumbnails/20.jpg)
Ventriculografía nuclear (99mTc Glóbulos Rojos)
![Page 21: Cardiologia Nuclear](https://reader035.vdocuments.mx/reader035/viewer/2022062220/55792f2bd8b42ad6678b46aa/html5/thumbnails/21.jpg)
cortes tomográficos cardíacos
![Page 22: Cardiologia Nuclear](https://reader035.vdocuments.mx/reader035/viewer/2022062220/55792f2bd8b42ad6678b46aa/html5/thumbnails/22.jpg)
Gated spect cuantitativo (Germano)
![Page 24: Cardiologia Nuclear](https://reader035.vdocuments.mx/reader035/viewer/2022062220/55792f2bd8b42ad6678b46aa/html5/thumbnails/24.jpg)
Hipertrofia VD
![Page 25: Cardiologia Nuclear](https://reader035.vdocuments.mx/reader035/viewer/2022062220/55792f2bd8b42ad6678b46aa/html5/thumbnails/25.jpg)
Infarto lateral
![Page 26: Cardiologia Nuclear](https://reader035.vdocuments.mx/reader035/viewer/2022062220/55792f2bd8b42ad6678b46aa/html5/thumbnails/26.jpg)
Reposo con dolor, CK y troponina normales
![Page 27: Cardiologia Nuclear](https://reader035.vdocuments.mx/reader035/viewer/2022062220/55792f2bd8b42ad6678b46aa/html5/thumbnails/27.jpg)
Isquemia inferolateral
Stress
reposo
![Page 28: Cardiologia Nuclear](https://reader035.vdocuments.mx/reader035/viewer/2022062220/55792f2bd8b42ad6678b46aa/html5/thumbnails/28.jpg)
![Page 29: Cardiologia Nuclear](https://reader035.vdocuments.mx/reader035/viewer/2022062220/55792f2bd8b42ad6678b46aa/html5/thumbnails/29.jpg)
Perfusión miocardíac 3d y cuantitativa
![Page 30: Cardiologia Nuclear](https://reader035.vdocuments.mx/reader035/viewer/2022062220/55792f2bd8b42ad6678b46aa/html5/thumbnails/30.jpg)
![Page 31: Cardiologia Nuclear](https://reader035.vdocuments.mx/reader035/viewer/2022062220/55792f2bd8b42ad6678b46aa/html5/thumbnails/31.jpg)
Perfusión miocárdica
Territorios vasculares
![Page 32: Cardiologia Nuclear](https://reader035.vdocuments.mx/reader035/viewer/2022062220/55792f2bd8b42ad6678b46aa/html5/thumbnails/32.jpg)
Isquemiamoderada
severa
![Page 33: Cardiologia Nuclear](https://reader035.vdocuments.mx/reader035/viewer/2022062220/55792f2bd8b42ad6678b46aa/html5/thumbnails/33.jpg)
Defectos fijos (sin isquemia)
![Page 34: Cardiologia Nuclear](https://reader035.vdocuments.mx/reader035/viewer/2022062220/55792f2bd8b42ad6678b46aa/html5/thumbnails/34.jpg)
Hipertrofia ventricular derecha
![Page 35: Cardiologia Nuclear](https://reader035.vdocuments.mx/reader035/viewer/2022062220/55792f2bd8b42ad6678b46aa/html5/thumbnails/35.jpg)
Viabilidad miocárdica Tl201
stress
reposo
24 horas
![Page 36: Cardiologia Nuclear](https://reader035.vdocuments.mx/reader035/viewer/2022062220/55792f2bd8b42ad6678b46aa/html5/thumbnails/36.jpg)
Isquemia lateral
![Page 37: Cardiologia Nuclear](https://reader035.vdocuments.mx/reader035/viewer/2022062220/55792f2bd8b42ad6678b46aa/html5/thumbnails/37.jpg)
Detección de enfermedad coronaria significativa
93%85%Perfusión miocárdica
en estenosis >50%
80%65%Prueba de esfuerzo
95%95%perfusión miocárdica
en estenosis >70%
especificidad sensibilidad
![Page 38: Cardiologia Nuclear](https://reader035.vdocuments.mx/reader035/viewer/2022062220/55792f2bd8b42ad6678b46aa/html5/thumbnails/38.jpg)
Viabilidad miocárdica (PET)
![Page 39: Cardiologia Nuclear](https://reader035.vdocuments.mx/reader035/viewer/2022062220/55792f2bd8b42ad6678b46aa/html5/thumbnails/39.jpg)
Infarto inferior
![Page 40: Cardiologia Nuclear](https://reader035.vdocuments.mx/reader035/viewer/2022062220/55792f2bd8b42ad6678b46aa/html5/thumbnails/40.jpg)
![Page 41: Cardiologia Nuclear](https://reader035.vdocuments.mx/reader035/viewer/2022062220/55792f2bd8b42ad6678b46aa/html5/thumbnails/41.jpg)
Dipiridamolvasodilatador inhibidor adenosindeaminasa
reposo dipiridamol
![Page 42: Cardiologia Nuclear](https://reader035.vdocuments.mx/reader035/viewer/2022062220/55792f2bd8b42ad6678b46aa/html5/thumbnails/42.jpg)
Incremento del flujo coronario
![Page 43: Cardiologia Nuclear](https://reader035.vdocuments.mx/reader035/viewer/2022062220/55792f2bd8b42ad6678b46aa/html5/thumbnails/43.jpg)
Isquemia inferolateral
![Page 44: Cardiologia Nuclear](https://reader035.vdocuments.mx/reader035/viewer/2022062220/55792f2bd8b42ad6678b46aa/html5/thumbnails/44.jpg)
Perfusión miocárdica normal
![Page 45: Cardiologia Nuclear](https://reader035.vdocuments.mx/reader035/viewer/2022062220/55792f2bd8b42ad6678b46aa/html5/thumbnails/45.jpg)
Falso positivo de perfusión miocárdica
BCRIHH
Ejercicio: cronotropismo e inotropismo +Dipiridamol: stress vascularAdenosina: stress vascularDobutamina: cronotropismo e inotropismo +
![Page 46: Cardiologia Nuclear](https://reader035.vdocuments.mx/reader035/viewer/2022062220/55792f2bd8b42ad6678b46aa/html5/thumbnails/46.jpg)
Isquemia anteroseptal e inferor (dipiridamol)
![Page 47: Cardiologia Nuclear](https://reader035.vdocuments.mx/reader035/viewer/2022062220/55792f2bd8b42ad6678b46aa/html5/thumbnails/47.jpg)
INDICACIONES
• 11. Angina Típica , EKG -, PE – . Angina Típica , EKG -, PE – • 22. Angina Atípica, EKG +, PE +. Angina Atípica, EKG +, PE +• 33. Valorar Isquemia de estenosis . Valorar Isquemia de estenosis
coronaria crítica o coronaria crítica o subcríticasubcrítica
• 44. Definir isquemia residual post . Definir isquemia residual post IM (4a semana)IM (4a semana)
• 55. Evaluar isquemia post RVM, o . Evaluar isquemia post RVM, o post angioplastiapost angioplastia
• 66. Valorar resultados de . Valorar resultados de trombolisistrombolisis
Perfusion Miocárdica
![Page 48: Cardiologia Nuclear](https://reader035.vdocuments.mx/reader035/viewer/2022062220/55792f2bd8b42ad6678b46aa/html5/thumbnails/48.jpg)
Isquemia inferolateral residual
![Page 49: Cardiologia Nuclear](https://reader035.vdocuments.mx/reader035/viewer/2022062220/55792f2bd8b42ad6678b46aa/html5/thumbnails/49.jpg)
Isquemia inducida por dipiridamol
![Page 50: Cardiologia Nuclear](https://reader035.vdocuments.mx/reader035/viewer/2022062220/55792f2bd8b42ad6678b46aa/html5/thumbnails/50.jpg)
![Page 51: Cardiologia Nuclear](https://reader035.vdocuments.mx/reader035/viewer/2022062220/55792f2bd8b42ad6678b46aa/html5/thumbnails/51.jpg)
DETERIORO EN LA CLASE FUNCIONAL como equivalente anginoso. Hombre de 72 años con
trasplante renal hace 30 años
![Page 52: Cardiologia Nuclear](https://reader035.vdocuments.mx/reader035/viewer/2022062220/55792f2bd8b42ad6678b46aa/html5/thumbnails/52.jpg)
Talio201 (planar)
Talio 201 Isonitrilos(Tc) : MIBITetrofosmin(Tc)
![Page 53: Cardiologia Nuclear](https://reader035.vdocuments.mx/reader035/viewer/2022062220/55792f2bd8b42ad6678b46aa/html5/thumbnails/53.jpg)
Aneurisma apical post infarto
![Page 54: Cardiologia Nuclear](https://reader035.vdocuments.mx/reader035/viewer/2022062220/55792f2bd8b42ad6678b46aa/html5/thumbnails/54.jpg)
Fracción eyección 16% (insuficiencia aórtica)
![Page 55: Cardiologia Nuclear](https://reader035.vdocuments.mx/reader035/viewer/2022062220/55792f2bd8b42ad6678b46aa/html5/thumbnails/55.jpg)
Angiocardiografía nuclear, shunt 1.5
![Page 56: Cardiologia Nuclear](https://reader035.vdocuments.mx/reader035/viewer/2022062220/55792f2bd8b42ad6678b46aa/html5/thumbnails/56.jpg)
Angiocardiografía nuclear (shunt 2.4)
![Page 57: Cardiologia Nuclear](https://reader035.vdocuments.mx/reader035/viewer/2022062220/55792f2bd8b42ad6678b46aa/html5/thumbnails/57.jpg)
![Page 58: Cardiologia Nuclear](https://reader035.vdocuments.mx/reader035/viewer/2022062220/55792f2bd8b42ad6678b46aa/html5/thumbnails/58.jpg)
Isquemia inferolateral inducida por dipiridamol; 51 años, dislipidemia mixta,
angina post RVM y angioplastia
![Page 59: Cardiologia Nuclear](https://reader035.vdocuments.mx/reader035/viewer/2022062220/55792f2bd8b42ad6678b46aa/html5/thumbnails/59.jpg)
Perfusión miocárdica
Mapas polares (bulls eye)stress (dipiridamol) reposo reversa
![Page 60: Cardiologia Nuclear](https://reader035.vdocuments.mx/reader035/viewer/2022062220/55792f2bd8b42ad6678b46aa/html5/thumbnails/60.jpg)