In this case-based educational video, nuclear medicine specialist Dr. Ziad Risheq presents a cardiac SPECT study of a 53-year-old male patient with a history of ischemic heart disease, presenting with chest pain and dyspnea. The video walks viewers through the diagnostic reasoning process, interpretation of stress myocardial perfusion imaging (MPI), and the relevance of achieving target heart rates for accurate assessment. Dr. Risheq highlights the impact of suboptimal stress levels on sensitivity and specificity, and discusses perfusion findings, ECG results, gated images, and clinical decision-making.

Learning Objectives:

After watching this video, learners will be able to:

• Understand the role of SPECT MPI in assessing ischemia in patients with reduced left ventricular systolic function.
• Recognize the importance of achieving ≥85% of the maximum predicted heart rate during stress testing to ensure diagnostic accuracy.
• Interpret perfusion images including short and long axis views to identify areas of ischemia or infarction.
• Evaluate gated SPECT images to correlate perfusion abnormalities with wall motion and ejection fraction.
• Apply clinical reasoning to determine whether a patient with reduced EF may benefit from revascularization or is best managed medically.