[Use of 99mTc-pyrophosphate and coronarography in the diagnosis of simultaneous myocardial infarct of the right and left cardiac ventricles].

: Myocardial scintigraphy was performed using 99m-Tc-pyrophosphate in 50 patients with suspected coexisting right ventricular and left inferior ventricular heart infarction and in 50 patients with left inferior ventricular infraction only. In all survived patients additional selective coronarography was performed and in all died patients autopsy was performed. The aim of the study was to evaluate reliability of myocardial scintigraphy using 99m-Tc-pyrophosphate in the diagnosis of coexisting infarction of both heart ventricles. In a group of patients with coexisting right and left ventricular infarction (45 proved by coronarography, and 5 by autopsy), scintigraphic finding was confirmed in 46 (93%) patients. In all 50 patients with left inferior ventricular infarction, scintigraphic finding was confirmed in 48 of them by coronarography and in 2 by autopsy (100%). Of 4 patients with false negative scintigraphic finding 2 were treated with fibrinolytic therapy immediately after admission and in 2 diffuse occlusive changes were found on all three blood vessels by coronarography. It has been concluded that myocardial scintigraphy using 99m-Tc-pyrophosphate is a very sensitive (92%), specific (100%), exact (96%), simple and safe diagnostical method in detecting coexisting acute infarction of both heart ventricles.