RT Journal Article SR Electronic T1 Prominent Right Ventricular Tracer Uptake: A Harbinger of Multivessel Coronary Artery Disease JF Journal of Nuclear Medicine Technology JO J. Nucl. Med. Technol. FD Society of Nuclear Medicine SP jnmt.125.270002 DO 10.2967/jnmt.125.270002 A1 Adam, Adam A1 Malhotra, Saurabh YR 2025 UL http://tech.snmjournals.org/content/early/2025/04/22/jnmt.125.270002.abstract AB A 65-y-old woman with multiple cardiovascular risk factors presented with atypical chest pain, prompting a 1-d pharmacologic stress myocardial perfusion test using 99mTc sestamibi. Initial interpretation suggested ischemia, but closer inspection revealed increased right ventricular uptake and increased left ventricular chamber size at stress, indicative of significant 3-vessel coronary artery disease (CAD). These findings were confirmed by cardiac catheterization, showing 3-vessel disease, including significant left main CAD. The patient underwent coronary artery bypass graft surgery. This case highlights the importance of meticulous SPECT image interpretation, particularly focusing on right ventricular uptake and transient ischemic dilation, to accurately diagnose severe CAD and improve cardiovascular outcomes.