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Esophageal and tracheal activity during myocardial scintigraphy with Tc-99m sestamibi: a case report.

A 78-year-old woman underwent a dipyridamole stress test with Tc-99m sestamibi after a myocardial infarction. Her course of hospitalization had been complicated by upper gastrointestinal bleeding, respiratory failure resulting from aspiration pneumonia that required tracheostomy and mechanical ventilation, and a cerebrovascular accident that required a gastrostomy tube for feeding. Myocardial perfusion SPECT showed apical ischemia. Marked intraluminal gastric activity, extending throughout the entire esophagus and into the trachea, was observed incidentally. This finding was observed on planar and SPECT images. The pattern observed was strongly suggestive of duodenogastric reflux, severe gastroesophageal reflux, and subsequent tracheal aspiration.