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    TID and atrial fibrillation Pre-op evaluation

    Teaching Case

    Case presentation:

    • Female.
    • 75 y.o.
    • Hypertension, moderate overweight, dyslipidemia.
    • Asymptomatic, pre-op evaluation (gynecological).
    • Medication: ACEI, B-blockers.
    • ECG: Atrial fibrillation (AF), average HR 80 bpm, otherwise normal.
    • Echo: LVEF 48%, no WMA. - Referred for MPS w/ pharmacologic stress.
    • Dipyridamole + rest (2-day protocol); no symptoms, no ECG changes other than previously known AF, BP 135/80 mmHg.

    ?Teaching points:

    • QC data is important info when interpreting gated perfusion studies.
    • AF and other arrhythmias can cause false EF values.
    • Before considering TID, look at HR during acquisition.
    • Changes above 10 bpm between acquisitions can cause difference in LV volume calculation.

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