Persistent Sub-diaphragmatic Activity on the Myocardial Perfusion Scan with 99mTc-Sestamibi

We present a female patient with atypical chest pain who was referred to our department for ischemia evaluation. 99mTc-MIBI myocardial perfusion scan with dipyridamole stress was performed. Sub-diaphragmatic activity in the hepatic tissue and then in the bowel loops caused severe overlap on the inferior wall even on consecutive delayed images. Dipyridamole stress was repeated for the patient with 201Tl. The study was interpretable this time without any interfering sub-diaphragmatic activity.