Case One: PHH Male/54

The patient is a 54 year old Chinese man who complains of exertional dyspnoea for the past 3 months. He is overweight and has mild hyperlipidemia. He denies other risk factors such as diabetes, hypertension or smoking.

Physical examination was unremarkable except for obesity (weight 102 kg). Heart sounds S1 S2, regular with no murmurs.

Blood pressure 138/80 mmHg. Lungs clinically clear.

Chest X-ray: Within normal limits.

ECG: Non-specific ST and T wave flattening.

In view of the possibility of his symptoms being due to ischaemic disease with angina equivalent, stress testing was attempted, but the patient was unable to perform adequate treadmill exercise.

A myocardial perfusion study using dipyridamole sestamibi SPECT was performed.


Images:

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Stress-rest images using gray scale (83KB)		Stress-rest images using colour scale (110KB)
Stress-rest images using 10 step colour scale (131KB)		Quantitative analysis of perfusion (113KB)

Questions:

Is the study normal?
What is the risk of subsequent cardiac events?
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