Differential Diagnosis
- Single most likely diagnosis
- Coronary Artery Disease (CAD): The mildly reduced radiotracer uptake in apical and mid inferior lateral segments, septal hypokinesis, and moderate risk for cardiac events are consistent with CAD. The transient ischemic dilatation (TID) ratio of 1.13 also supports this diagnosis, as it indicates a stress-induced increase in left ventricular volume.
- Other Likely diagnoses
- Cardiac Syndrome X: This condition is characterized by chest pain and evidence of myocardial ischemia, but without significant CAD. The mildly reduced radiotracer uptake and septal hypokinesis could be consistent with this diagnosis.
- Hypertrophic Cardiomyopathy: The septal hypokinesis and mildly reduced radiotracer uptake could be seen in hypertrophic cardiomyopathy, especially if there is asymmetric septal hypertrophy.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Acute Coronary Syndrome (ACS): Although the left ventricular ejection fraction (LVEF) is relatively preserved, the presence of septal hypokinesis and mildly reduced radiotracer uptake warrants consideration of ACS, which requires prompt recognition and treatment.
- Cardiac Sarcoidosis: This condition can cause septal hypokinesis and reduced radiotracer uptake, and can be life-threatening if not recognized and treated.
- Rare diagnoses
- Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC): Although the study focuses on left ventricular function, ARVC can cause septal hypokinesis and reduced radiotracer uptake, and is a rare but important consideration.
- Left Ventricular Non-Compaction (LVNC): This rare cardiomyopathy can cause septal hypokinesis and reduced radiotracer uptake, and can be associated with increased risk of cardiac events.