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Tc-99m sestamibi esophageal activity during myocardial imaging.

A 75-year-old woman with atypical chest pain was referred for a two-day protocol stress/rest dipyridamole Tc-99m sestamibi myocardial perfusion study. Myocardial perfusion was normal, but, unexpectedly, extensive linear activity in a distribution corresponding to the esophagus was detected on both studies. A diagnosis of noncardiac chest pain due to duodeno-gastro-esophageal bile reflux was made in view of normal myocardial perfusion and the recurrent copious esophageal activity on the two separate examination days. This case stresses the importance of actively searching for ancillary findings when performing functional nuclear medicine imaging.