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ARTICLE |

Is There a Need for Additional Means of Recognizing Myocardial Necrosis? FREE

James T. Willerson, MD; Robert W. Parkey, MD; L. Maximilian Buja, MD; Frederick J. Bonte, MD
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Address editorial communications to the Editor, 535 N Dearborn St, Chicago 60610


JAMA. 1977;238(15):1665-1666. doi:10.1001/jama.1977.03280160059031
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One might logically question whether there is a need for additional techniques to recognize the presence of acute myocardial infarcts in patients. Traditionally, the ECG and serum measurement of cardiac enzymes have been used to detect the presence or absence of acute myocardial necrosis resulting from coronary artery disease. For recognizing acute myocardial infarcts, these techniques are adequate in many patients, providing an absolute differentiation between the presence of acute myocardial infarction and other coronary artery disease syndromes, including angina pectoris and acute myocardial ischemia. However, there are subgroups of patients who come to the hospital with chest pain, in whom it is difficult to determine with accuracy whether they have had acute myocardial infarcts when just the ECG and cardiac enzymes are used alone.

In particular, patients who arrive at the hospital 16 or more hours after the onset of chest pain, those with conduction abnormalities on their ECG,

REFERENCES

Bonte FJ, Parkey RW, Graham KD, et al:  A new method for radionuclide imaging of myocardial infarcts . Radiology 110:473-474, 1974;.
Parkey RW, Bonte FJ, Meyer SL, et al:  A new method for radionuclide imaging of acute myocardial infarction in humans . Circulation 50:540-546, 1974;.
Willerson JT, Parkey RW, Bonte FJ, et al:  Technetium stannous pyrophosphate myocardial scintigrams in patients with chest pain of varying etiology . Circulation 51:1046-1052, 1975;.
Willerson JT, Parkey RW, Bonte FJ, et al:  Acute subendocardial myocardial infarction in patients: Its detection by technetium 99m stannous pyrophosphate myocardial scintigrams . Circulation 51:436-441, 1975;.
Buja LM, Parkey RW, Dees JH, et al:  Morphologic correlates of technetium-99m stannous pyrophosphate imaging of acute myocardial infarcts in dogs . Circulation 52:596-607, 1975;.
Buja LM, Parkey RW, Stokely EM, et al:  Pathophysiology of technetium99m stannous pyrophosphate and thallium-201 scintigraphy of acute anterior myocardial infarctions in dogs .J Clin Invest 57:1508-1522, 1976;.
D'Agostino AN, Chiga M:  Mitochondrial mineralization in human myocardium . Am J Clin Pathol 53:820-824, 1970;.
Shen AC, Jennings RB:  Myocardial calcium and magnesium in acute ischemic injury . Am J Pathol 67:417-434, 1972;.
Willerson JT, Parkey RW, Bonte FJ, et al:  Technetium stannous pyrophosphate myocardial scintigraphy: A new method of proven value for the diagnosis and localization of acute myocardial infarcts and for the detection of infarct extension in patients . Tex Med 72:61-66, 1976;.
Pugh BR, Buja LM, Parkey RW, et al:  Cardioversion and its potential role in the production of "false positive" technetium-99m stannous pyrophosphate myocardial scintigrams . Circulation 54:399-403, 1976;.
Harford W, Weinberg M, Buja LM, et al:  Positive technetium-99m stannous pyrophosphate myocardial scintigram in a patient with carcinoma of the lung . Radiology 122:747-748, 1977;.
Stokely EM, Buja LM, Lewis SE, et al:  Measurement of acute myocardial infarcts in dogs with technetium-99m stannous pyrophosphate scintigrams . J Nucl Med 17:1-5, 1976;.
Lewis M, Buja LM, Saffer S, et al:  Experimental infarct sizing utilizing computer processing and a three-dimensional model . Science 197:167-169, 1977;.
Platt MR, Mills LJ, Parkey RW, et al:  Perioperative myocardial infarction diagnosed by technetium-99m stannous pyrophosphate myocardial scintigrams . Circulation 54( (suppl 3) ):24-27, 1976;.
Stokely EM, Parkey RW, Bonte FJ, et al:  Gated blood pool imaging following technetium-99m phosphate scintigraphy . Radiology 120:433-434, 1976;.

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Bonte FJ, Parkey RW, Graham KD, et al:  A new method for radionuclide imaging of myocardial infarcts . Radiology 110:473-474, 1974;.
Parkey RW, Bonte FJ, Meyer SL, et al:  A new method for radionuclide imaging of acute myocardial infarction in humans . Circulation 50:540-546, 1974;.
Willerson JT, Parkey RW, Bonte FJ, et al:  Technetium stannous pyrophosphate myocardial scintigrams in patients with chest pain of varying etiology . Circulation 51:1046-1052, 1975;.
Willerson JT, Parkey RW, Bonte FJ, et al:  Acute subendocardial myocardial infarction in patients: Its detection by technetium 99m stannous pyrophosphate myocardial scintigrams . Circulation 51:436-441, 1975;.
Buja LM, Parkey RW, Dees JH, et al:  Morphologic correlates of technetium-99m stannous pyrophosphate imaging of acute myocardial infarcts in dogs . Circulation 52:596-607, 1975;.
Buja LM, Parkey RW, Stokely EM, et al:  Pathophysiology of technetium99m stannous pyrophosphate and thallium-201 scintigraphy of acute anterior myocardial infarctions in dogs .J Clin Invest 57:1508-1522, 1976;.
D'Agostino AN, Chiga M:  Mitochondrial mineralization in human myocardium . Am J Clin Pathol 53:820-824, 1970;.
Shen AC, Jennings RB:  Myocardial calcium and magnesium in acute ischemic injury . Am J Pathol 67:417-434, 1972;.
Willerson JT, Parkey RW, Bonte FJ, et al:  Technetium stannous pyrophosphate myocardial scintigraphy: A new method of proven value for the diagnosis and localization of acute myocardial infarcts and for the detection of infarct extension in patients . Tex Med 72:61-66, 1976;.
Pugh BR, Buja LM, Parkey RW, et al:  Cardioversion and its potential role in the production of "false positive" technetium-99m stannous pyrophosphate myocardial scintigrams . Circulation 54:399-403, 1976;.
Harford W, Weinberg M, Buja LM, et al:  Positive technetium-99m stannous pyrophosphate myocardial scintigram in a patient with carcinoma of the lung . Radiology 122:747-748, 1977;.
Stokely EM, Buja LM, Lewis SE, et al:  Measurement of acute myocardial infarcts in dogs with technetium-99m stannous pyrophosphate scintigrams . J Nucl Med 17:1-5, 1976;.
Lewis M, Buja LM, Saffer S, et al:  Experimental infarct sizing utilizing computer processing and a three-dimensional model . Science 197:167-169, 1977;.
Platt MR, Mills LJ, Parkey RW, et al:  Perioperative myocardial infarction diagnosed by technetium-99m stannous pyrophosphate myocardial scintigrams . Circulation 54( (suppl 3) ):24-27, 1976;.
Stokely EM, Parkey RW, Bonte FJ, et al:  Gated blood pool imaging following technetium-99m phosphate scintigraphy . Radiology 120:433-434, 1976;.
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