Importance of ST-Segment Depression during Dipyridamole (superscript 201)Tl Myocardial Perfusion Imaging in the Diagnosis of Multivessel Coronary Artery Disease

We describe a case of a 72-year-old female who underwent dipyridamole (superscript 201)TI myocardial perfusion imaging for the evaluation of coronary artery disease (CAD). The images showed no transient or fixed defect, but ST-segment depression on electrocardiography was noted after dipyridamole administration. Coronary angiography demonstrated multiple significant stenosis in the left main, left circumflex, and left anterior descending coronary arteries. Thus, dipyridamole-induced ST-segment depression (DISTD) helped to identify the multivessel CAD. In this article, we emphasize that normal dipyridamole (superscript 201)TI myocardial perfusion images with DISTD still suggests the presence of CAD.