The full content of Annals is available to subscribers

Subscribe/Learn More  >
Editorials |

The Value of Exercise Thallium Imaging

K. Michael Zabel, MD; and Robert M. Califf, MD
[+] Article, Author, and Disclosure Information

Duke University Medical Center, Durham, NC 27710. Requests for Reprints: Robert M. Califf, MD, Department of Medicine, Division of Cardiology, Box 31123, Duke University Medical Center, Durham, NC 27710.

Copyright ©2004 by the American College of Physicians

Ann Intern Med. 1994;121(11):891-893. doi:10.7326/0003-4819-121-11-199412010-00013
Text Size: A A A

Physicians can choose from among many diagnostic techniques to evaluate patients with known or suspected ischemic heart disease. The physician wishing to determine whether a patient who has symptoms consistent with angina has significant coronary artery stenosis can order a stress electrocardiogram, stress echocardiogram, radionuclide ventriculogram, coronary angiogram, or nuclear perfusion imaging test. Within this last category alone are dozens of variations, including isotope (thallium or sestamibi or teboroxime), acquisition method (planar or tomographic [single-photon emission computed tomography]), stressor (exercise or dobutamine or dipyridamole or adenosine), analysis technique (qualitative or quantitative), and many other technical variables (for example, the time to reimaging after exercise and at-rest reinjection of the imaging agent). Each of these methods varies in cost, complexity, reproducibility, safety, patient comfort, and ability to answer specific questions. The challenge for the physician, therefore, is to choose the best technique for a given patient at a given time for a given question of clinical interest. The most appropriate choice depends on the characteristics of the patient being studied, the local institutional expertise, and, even more importantly, the question being addressed.

First Page Preview

View Large
First page PDF preview





Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).


Submit a Comment/Letter
Submit a Comment/Letter

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.


Buy Now for $32.00

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Related Articles
Related Point of Care
Topic Collections
PubMed Articles
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.