Myocardial nuclear imaging provides valuable anatomic and prognostic information with respect to coronary heart disease. There are, however, important limitations to this imaging. To understand the proper clinical interpretation of perfusion imaging scans it is important understand the basic principles of coronary blood flow, atherosclerosis, and the principles underlying nuclear perfusion imaging.

• To understand why nuclear imaging works with respect to the Glagov Phenomenon and the stenosis – coronary blood flow relationship
• To describe the ischemic cascade with respect to the relationship of coronary ischemia and clinical findings
• To explain the causes of the limited sensitivity and specificity of myocardial perfusion imaging
• To interpret typical findings of myocardial perfusion imaging