Reverse Redistribution in Myocardial Perfusion Imaging: Revisited with 64-slice MDCT

Abstract

The authors report myocardial perfusion imaging of a patient showing reverse redistribution (RR) and a 64-slice multidetector-row computed tomography (MDCT) with corresponding findings. The patient had subendocardial myocardial infarction (MI) with positive electrocardiogram (EKG) findings and elevated levels of cardiac isoenzymes. Experiencing this case emphasizes the importance of complementary correlation of a new diagnostic modality that helps us to understand the nature of RR.Keywords Reverse redistribution . Myocardial perfusion imaging . 64-slice multidetector-row CT . Subendocardial MI Fig. 1 The patient was a 49-year-old man with a 1-year history of diabetes mellitus and hypertension, who was admitted with chest pain and ventricular fibrillation to rule out an acute myocardial infarction (MI). CK-MB and troponin were abnormally elevated. The electrocardiogram (EKG) after DC cardioversion shows prominent ST elevation in leads II, III, aVF, and V 5-6 , findings suggestive for subendocardial MI in the inferior wall. A coronary angiogram showed a total occlusion of the distal left circumflex artery (LCX). A followup EKG showed no Q-wave