Radionuclide imaging of Chagas cardiomyopathy

Images of a 63-year-old man presenting with syncope due to episodes of sustained ventricular tachycardia with Chagas cardiomyopathy and normal echocardiogram. This figure shows ^99mTc sestamibi myocardial perfusion SPECT images for assessment of myocardial viability and ¹²³I MIBG myocardial SPECT (lower rows) for assessment of cardiac sympathetic innervation. There is a large defect in ¹²³I MIBG uptake involving the inferior and apical walls with corresponding normal ^99mTc sestamibi uptake, consistent with viable but denervated myocardium.