Extent and Severity of Coronary Heart Disease

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Abstract
Rest and exercise ECGs are the most widely used "noninvasive" tests for detecting coronary heart disease, but their sensitivity and specificity are suboptimal. Therefore, the diagnostic value of myocardial perfusion scanning using thallous chloride TI 201 during rest and stress electrocardiography was examined in 95 patients with a chest discomfort syndrome. Overall, thallous chloride TI 201 perfusion scanning had a sensitivity of 75% and a specificity of 91% for coronary heart disease compared with 56% sensitivity and 86% specificity with exercise-induced ST segment depression on the ECG. Combining rest and stress ECGs resulted in a sensitivity of 71%. In patients with coronary heart disease, perfusion scanning had a sensitivity of 93% for asynergy compared with 58% for exercise-induced ECG ST depression. Rest and stress myocardial perfusion scanning with thallous chloride TI 201 provides improved sensitivity with good specificity in the diagnosis of coronary heart disease compared with exercise electrocardiography alone. (Arch Intern Med 139:630-634, 1979)