Role of gated myocardial perfusion scintigraphy in pre-operative cardiac risk stratification for non-cardiac surgery in cancer patients.

Coronary artery disease (CAD) is a silent killer that may go undetected for years. It is the leading cause of death at the same time cancer by itself is associated with coagulation disorders due to hypercoagulable state and can cause coronary thromboemboli. However there is no definite evidence that cancer by itself predisposes to coronary atherosclerosis. Optimal management of cancer patients with such known risk factors for coronary artery disease (CAD) includes assessing risk of future cardiac events particularly myocardial infarction (MI) and death. There is no single test that can diagnose or stratifies risk of having CAD. Myocardial perfusion imaging is the only non-invasive method of assessing myocardial perfusion. This project was undertaken at the Nuclear Medicine department Shaukat Khanum Memorial Cancer Hospital and Research center Pakistan to see the utility of MP imaging in preoperative risk assessment in cancer patients who are undergoing major surgery.