In this nuclear cardiology case review, a 48-year-old male with a history of coronary artery bypass grafting (CABG) presents with exertional chest discomfort and dyspnea. Despite a recent echocardiogram showing preserved systolic function, a myocardial perfusion SPECT study is performed to evaluate for graft-related ischemia. The case walks viewers through stress and rest imaging interpretation, highlighting a reversible perfusion defect suggestive of ischemia in the graft territory. The video emphasizes key technical and diagnostic considerations in post-CABG patients, including the impact of submaximal stress on image accuracy.

Learning Objectives:

After watching this video, learners will be able to:

• Assess myocardial perfusion in post-CABG patients using gated SPECT imaging.
• Identify reversible perfusion defects indicative of stress-induced ischemia.
• Understand limitations of suboptimal stress testing and its impact on diagnostic accuracy.
• Compare stress and rest perfusion images to localize and characterize ischemia.
• Integrate imaging findings with clinical context to support management decisions in patients with previous bypass surgery.