Scan Findings of Ischaemic Heart Disease in Adults Aged 30-40 Years Old as Detected and Evaluated on Myocardial Perfusion Scintigraphy

Introduction: 
Ischaemic heart disease (IHD) is on the rise among adults under 40-years. Radionuclide myocardial perfusion scintigraphy (MPS) can provide imaging information to diagnose, evaluate and risk stratify IHD. Nevertheless, local data are limited on the usage of this technique in identifying IHD among young adult patients. Our objectives were to determine important clinical characteristics of these patients who underwent MPS for IHD detection and highlight their scintigraphy findings.    

Methodology: 
A case-series and pictorial review of adults aged 30-40 years old (n=34) who had two-day protocol MPS using 99mTechnetium-tetrofosmin done between January and December 2019. Scan acquisition being performed as per standard departmental protocol. Reversible perfusion defect signified ischaemia whereas irreversible perfusion defect implied infarction. Clinical information and scan findings were compiled and analysed.    

Results: 
Average age was 36.59 years. Females were predominant (n=19, 55.9%). Majority had ≥2 cardiovascular risk factors (n=22, 64.7%). Small proportion of patients had morbid obesity (n=3, 8.8%) and intermediate risk for pre-test IHD probability (n=12, 35.3%). Imaging findings of MPS included normal perfusion (n=9, 26.5%), artifact (n=1, 2.9%), ischemia (n=23, 67.6%) and infarction (n=1, 2.9%). Mean ejection fraction on stress MPS was 66%. Patients with ≥2 cardiovascular risks and intermediate probability were significantly associated with abnormal MPS findings (p<0.05).    

Conclusions: 
IHD was observed in 70.5% of adults under 40-years who were referred for MPS. Those who had ≥2 cardiovascular risks and intermediate probability were significantly associated with abnormal MPS findings. Attention should be given during scintigraphy images interpretation and reporting of these particular patients.
 

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