Reliability of gated heart scintigrams for detection of left-ventricular aneurysm: concise communication.

Gated heart scintigrams and angiocardiograms were performed on 138 patients with coronary artery disease. Scintigraphy detected 61 of 64 left-ventricular aneurysms demonstrated by angiography. The scintigram correctly identified all 54 apical and anteroapical aneurysms and one inferior aneurysm, but missed one of six anterior and two of three posterobasal aneurysms. In 74 patients with angiograms negative for aneurysm, the scintigram was also negative in 72, with two false positives. Overall accuracy of gated heart scintigraphy for the detection of aneurysm was 96% (133/138). Cardiac surgery was performed on 76 patients, and the angiographic findings were confirmed in all cases. Scintigraphic findings were confirmed in 74 of 76 patients. Among ten patients scintigraphed before and after aneurysmectomy, problems were first recognized by the scintigram in three cases. Gated heart scintigraphy is recommended as a screening procedure for suspected left-ventricular aneurysm because of its high reliability in the apical and anterior portions of the heart, where most of the aneurysms occur.