Acute myocardial infarction followed by technetium-99m-sestamibi SPECT imaging and pathologic correlation.

A 79-yr-old man received thrombolytic therapy for acute myocardial infarction after injection with 99mTc-sestamibi and died shortly thereafter. Postmortem in situ SPECT imaging of the heart was performed. The heart was then removed and sectioned into short-axis slices, which were placed directly on the SPECT camera face for imaging, and examined by routine gross and microscopic pathologic methods. Pathologic findings were consistent with a small acute inferoseptal myocardial infarction, as demonstrated on both SPECT imaging of the intact heart and imaging of the heart slices. This case report provides further evidence of the validity of SPECT sestamibi imaging for the determination of myocardium at risk during acute myocardial infarction.