8. Evaluation of exercise induced stunning using myocardial perfusion imaging

Ischemia in women with angina and normal coronary angiograms

“…Clinical settings in which myocardial stunning has been demonstrated include percutaneous transluminal coronary angioplasty, unstable and variant angina, acute myocardial infarction with early reperfusion, cardiac surgery, and cardiac transplantation [26,27]. It can, however, also develop after silent or symptomatic ischemic episodes during daily activities and after diagnostic stress tests (either by physical or by pharmacological stress) with an ischemic response [25,[28][29][30].…”

Role of myocardial perfusion imaging for risk stratification in suspected or known coronary artery disease

“…31 Post-exercise ''stunning'' Recent observations have shown significant left ventricular chamber dilatation or wall thickening abnormality following delayed post-exercise imaging with thallium-201, or in particular, technetium-99m sestamibi SPECT studies, 30-90 minutes after cessation of exercise. [32][33][34][35] This phenomenon is thought to reflect post-ischaemic stunning or extensive subendocardial ischaemia. As technetium-99m sestamibi acts as a ''microsphere'', the perfusion is ''frozen'' at the time of injection, but wall thickening changes reflect real time events at the time of imaging rather than at injection.…”