Authors' objectives:

To provide guidance on the use of myocardial perfusion scintigraphy for the diagnosis and management of angina and myocardial infarction.

Authors' recommendations: Guidance: This appraisal covers the use of myocardial perfusion scintigraphy (MPS) using single photon emission computed tomography (SPECT) in the diagnosis and management of angina and myocardial infarction. It does not cover planar MPS or the use of MPS in the management of heart failure or in the assessment of myocardial viability. In this guidance the term coronary artery disease (CAD) is used to refer to angina and myocardial infarction. 1.1 MPS using SPECT is recommended for the diagnosis of suspected coronary artery disease (CAD) in the following circumstances. - As the initial diagnostic tool for people with suspected CAD for whom stress electrocardiography poses particular problems of poor sensitivity or difficulties in interpretation, including women, patients with cardiac conduction defects (for example, left bundle branch block), and people with diabetes, and for people for whom treadmill exercise is difficult or impossible. - As part of an investigational strategy for the diagnosis of suspected CAD in people with lower likelihood of CAD and of future cardiac events. The likelihood of CAD will be based on the assessment of a number of risk factors including age, gender, ethnic group, family history, associated comorbidities, clinical presentation, physical examination, and results from other investigations (for example, blood cholesterol levels or resting electrocardiogram). 1.2 MPS using SPECT is recommended as part of the investigational strategy in the management of established CAD in people who remain symptomatic following myocardial infarction or reperfusion interventions.

Authors' methods: Systematic review

Project Status: Completed

URL for project: http://www.nice.org.uk/cat.asp?c=94600

Year Published: 2003

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: England, United Kingdom

Organisation Name: National Institute for Clinical Excellence

Contact Address: MidCity Place, 71 High Holborn, London WC1V 6NA, UK. Tel: +44 020 7067 5800; Fax: +44 020 7067 5801

Contact Name: nice@nice.nhs.uk

Contact Email: nice@nice.nhs.uk

Copyright: National Institute for Clinical Excellence (NICE)