[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-533565-105":3,"detail-sidebar-cat-0-en-105":80,"doc-detail-533565-en":130},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":73,"head_meta":75,"extra_data":77,"updated_unix":79},105,"en","block-14","block 14","","Radionucleotide myocardial perfusion imaging using technetium Tc 99m tracers evaluates myocardial blood flow at rest and after stress to identify ischemia from differences in uptake. Normal rest and stress uptake suggests low likelihood of obstructive CAD, while reversible defects indicate inducible ischemia with likely hemodynamically significant narrowing. Reversible defects are managed with antiplatelet therapy and high-intensity statins alongside lifestyle modification. Beta-agonists, inotropes, and erythropoiesis-stimulating agents are discouraged for these settings, while oral biguanides are compared with broader cardiovascular risk reduction.",{"@graph":14,"@context":72},[15,34,55],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/exam/","Exam",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/block-14/533565/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/block-14/533565.png","ImageObject",300,407,{"name":42,"@type":43},"LangkahRina","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-29","2026-10-10",true,{"@type":52,"interactionType":53,"userInteractionCount":30},"InteractionCounter",{"@type":54},"ViewAction",{"@type":56,"mainEntity":57},"FAQPage",[58,64,68],{"name":59,"@type":60,"acceptedAnswer":61},"What does a reversible myocardial perfusion defect mean on nuclear stress testing?","Question",{"text":62,"@type":63},"A reversible defect shows normal tracer uptake at rest but decreased uptake with stress, indicating inducible ischemia and likely hemodynamically significant coronary narrowing.","Answer",{"name":65,"@type":60,"acceptedAnswer":66},"Which therapies are recommended when CAD is indicated by a reversible defect?",{"text":67,"@type":63},"Patients with suspected CAD should receive antiplatelet therapy (eg, aspirin) and a high-intensity statin (eg, atorvastatin or rosuvastatin), plus lifestyle modifications such as smoking cessation, routine exercise, and a healthy diet.",{"name":69,"@type":60,"acceptedAnswer":70},"Why are beta-adrenergic agonists avoided in patients with CAD?",{"text":71,"@type":63},"Beta-adrenergic agonists increase heart rate and contractility, raising myocardial oxygen demand and potentially worsening symptoms in CAD patients.","https://schema.org",{"og:url":32,"og:type":74,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":76,"canonical":32},"index,follow",{"doc_id":78,"site_id":7},533565,1792757336,{"code":4,"msg":81,"data":82},"success",[83,87,91,94,99,104,109,114,119,122,126],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":84,"show_sort_weight":85,"slug":86},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":88,"show_sort_weight":89,"slug":90},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":92,"slug":93},70,"exam",{"id":95,"doc_module":4,"doc_module_name":25,"category_name":96,"show_sort_weight":97,"slug":98},5,"Comic",60,"comic",{"id":100,"doc_module":4,"doc_module_name":25,"category_name":101,"show_sort_weight":102,"slug":103},6,"Technology",50,"technology",{"id":105,"doc_module":4,"doc_module_name":25,"category_name":106,"show_sort_weight":107,"slug":108},7,"Healthcare",40,"healthcare",{"id":110,"doc_module":4,"doc_module_name":25,"category_name":111,"show_sort_weight":112,"slug":113},8,"Research & Report",30,"research-report",{"id":115,"doc_module":4,"doc_module_name":25,"category_name":116,"show_sort_weight":117,"slug":118},9,"Religion & Spirituality",20,"religion-spirituality",{"id":117,"doc_module":4,"doc_module_name":25,"category_name":120,"show_sort_weight":117,"slug":121},"World Cup","world-cup",{"id":123,"doc_module":4,"doc_module_name":25,"category_name":124,"show_sort_weight":123,"slug":125},10,"Lifestyle","lifestyle",{"id":127,"doc_module":4,"doc_module_name":25,"category_name":128,"show_sort_weight":95,"slug":129},19,"General","general",{"code":4,"msg":81,"data":131},{"doc_id":78,"user_id":132,"nickname":42,"user_avatar":133,"doc_module":4,"category_id":33,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":30,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":139,"language":140,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":12,"update_tm":144,"read_time":145,"preview_page_count":4},962090893776,"https://ap-avatar.wpscdn.com/davatar_155a257f0dc6eb9ab79c44ca47cae57d","Settings  \nA47-year-old woman is evaluated for exertional dyspnea.Medical history includes type 2 diabetes mellitus,stage 3 chronic kidney disease,andmild normocytic anemia.The patient smokes a pack of cigarettes per day.Family history is insignificant.Blood pressure is 142/88 mm Hg andpulse is 76/min.BMl is 32 kg/m².Single photon emission CT scan of the heart is performed at rest and after 5 minutes of treadmill exercise byusing separate intravenous injections of technetium Tc 99m-labeled perfusion agent.In the scans shown below,the bottom panel is the patient'sheart at rest (REST)and the top is the heart after exercise (STRESS).  \nThis patient would benefit most from which of the following pharmacotherapies?  \nO A.Antiplatelet agent○ B.Beta-adrenergic agonist○ C.Erythropoiesis-stimulating agent○ D.Inotropic agent○ E.Oral biguanide agent  \nSubmit  \n三×  \n# Reversible myocardial perfusion defect\n\nRadionucleotide myocardial perfusion imaging(ie,nuclear stress testing)makes use of a technetium Tc 99m-labeled tracer(eg,sestamibi)toevaluate myocardial perfusion and test for obstructive coronary artery disease (CAD).The tracer is injected with the patient at rest and theinitial images are obtained (as shown in the bottom panel).The patient is then subjected to stress(via treadmill exercise or pharmacologicinducement)and images are obtained again (top panel).Any differences between the rest and stress images can help identify ischemia.  \n·Normal tracer uptake at rest and with stress indicates a low likelihood of obstructive CAD.  \n·Normal tracer uptake at rest but decreased uptake with stress (reversible defect)indicates inducible ischemia and likely ahemodynamically significant atherosclerotic narrowing that restricts exertional blood flow.  \n·Decreased tracer uptake at rest and with stress (fixed defect)indicates likely scar tissue,consistent with obstructive CAD with previousmyocardial infarction.  \nThis patient's findings indicate a reversible defect that is diagnostic of CAD.Patients with known CAD should be treated with antiplatelet therapy(eg,aspirin)and a high-intensity statin (eg,atorvastatin,rosuvastatin)to reduce the risk of myocardial infarction.In addition,lifestylemodifications(eg,smoking cessation,routine exercise,healthy diet)should be implemented to reduce cardiovascular risk  \n(Choice B)Beta-adrenergic agonists (eg,albuterol)increase heart rate and cardiac contractility to increase myocardial oxygen demand,and canworsen symptoms in patients with CAD.Beta blockers (eg,metoprolol)are often used to reduce symptoms in patients with CAD.  \n(Choice C)Erythropoietin stimulates erythropoiesis and is often used to treat moderate-severe anemia in patients with advanced chronic kidneydisease.However,this patient's anemia is mild,and her exertional symptoms are more likely due to obstructive CAD;erythropoietin is  \ncontraindicated for mild anemia because it can worsen cardiovas  \nScanned by   Camera Scanner  \nPrevi  \n*↓Perfusion(I tracer up  \nRadionucleotide myocardial perfusion imagingevaluate myocardial perfusion and test for obstrinitial images are obtained (as shown in the bottominducement)and images are obtained again (top pa  \n·Normal tracer uptake at rest and with stress i  \nHemoglobin  \nlevel(g/dL)  \n·Normal tracer uptake at rest but decreased uhemodynamically significant atherosclerotic n  \n·Decreased tracer uptake at rest and with stremyocardial infarction.  \nThis patient's findings indicate a reversible defect th(eg,aspirin)and a high-intensity statin (eg,atorvamodifications(eg,smoking cessation,routine exerc  \n(Choice B)Beta-adrenergic agonists (eg,albuteroworsen symptoms in patients with CAD.Beta block  \n(Choice C)Erythropoietin stimulates erythropoiesidisease.However,this patient's anemia is mild,an  \ncontraindicated for mild anemia because it can worsen caralovascular outcomes in such a setting.  \n(Choice D)Inotropic agents (eg,digoxin)increase cardiac contractility and worsen symptoms in patients with CAD.Theref","cbCaic88sUm4aAKL","https://ap.wps.com/l/cbCaic88sUm4aAKL","pdf",39394519,135,"English","# Nuclear stress testing and reversible myocardial perfusion defects\n## Stress vs rest perfusion interpretation\n## Treatment implications for CAD\n## Educational objective","[{\"question\":\"What does a reversible myocardial perfusion defect mean on nuclear stress testing?\",\"answer\":\"A reversible defect shows normal tracer uptake at rest but decreased uptake with stress, indicating inducible ischemia and likely hemodynamically significant coronary narrowing.\"},{\"question\":\"Which therapies are recommended when CAD is indicated by a reversible defect?\",\"answer\":\"Patients with suspected CAD should receive antiplatelet therapy (eg, aspirin) and a high-intensity statin (eg, atorvastatin or rosuvastatin), plus lifestyle modifications such as smoking cessation, routine exercise, and a healthy diet.\"},{\"question\":\"Why are beta-adrenergic agonists avoided in patients with CAD?\",\"answer\":\"Beta-adrenergic agonists increase heart rate and contractility, raising myocardial oxygen demand and potentially worsening symptoms in CAD patients.\"}]","block 14 | PDF",1791592536,340]