Prevalence and angiographic significance of normal myocardial perfusion SPECT with positive exercise electrocardiogram

In a consecutive series of 7350 myocardial perfusion SPECT studies, 66 (0.9%) nonrevascularized patients with a normal resting ECG had normal scintigraphic: findings with a positive ECG in the exercise test. We retrospectively analyzed 33 patients with coronary angiography, 26 of whom were women (P<.000). Twenty one of the 26 women (81%) and 1 of the 7 men (14%) had normal coronary angiographic: findings (PL=.004). Seven out of 11 patients with coronary heart disease had left main coronary artery or multivessel disease. We conclude that the,normal SPET with positive ECGmuch greater than pattern is infrequent, and is observed predominantly in women with normal coronary angiographic: findings. However, severe coronary artery disease cannot be ruled out in these patients, and this pattern should be considered a possible indication for coronary angiography.