الفهرس 
Acute myocardial infarctionOnly 14 pages are availabe for public view
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Abstract
The assessment of residual viability in the infracted area after an acute myocardial infarction is relevant to subsequent management and prognosis as revascularization may lead to functional improvement (Eitzman et al,1992).
The detection of viable myocardium requires a lot of diagnostic methods such as (single photon nuclear imaging techniques (SPECT), positron emission tomography (PET) with a metabolic agent, dobutamine echo, and more recently, delayed enhancement MRI. These studies are expensive,hence the need to find ways of selecting patients to undergo these studies such as resting surface ECG which is a simple, widely available and inexpensive method (Iskandrian et al., 2002).
The aim of this study is to investigate the correlation between myocardial viability after an acute anterior MI as assessed by Trimetazidine Tc99m sestamibi scan and the predischarge ECG patterns of ST segment and T wave abnormalities.
Patients & Methods
The study included fifty-two patients who had their first acute anterior myocardial infarction and received streptokinase as the reperfusion Therapy.
All Patients were subjected to full history with stress on risk factors, clinical examination, ECG on admission and predischrge ,peak CPK value was recorded. Resting Tc99m sestamibi imaging after TMZ intake was done prior to discharge to assess the viability in the infracted area and the infarction size. The 17 segment visual analysis for infarct size estimation was used to represent the entire left ventricle. Each of the 17 segments has a distinct name and number. A semiquantitative scoring system was used where each of the 17 segments was scored according to a 5 point – scheme.
The LAD artery territory included 9 segments and the score was obtained by adding the scores of those 9 segments.
For assessment of viability within the infracted area the radio tracer uptake was semi quantitatively assessed using visual colour score. The area considered viable if the uptake of radiotracer was > 50% of the normal areas.
Patients were divided according to ST segment in the predischarge ECG into two groups
Group I: with isoelectric ST segment.
Group II: with persistent ST segment elevation >0.1 mm.