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  1. Christian J M Vrints
  1. Correspondence to Christian J M Vrints, University of Antwerp/University Hospital, Wilrijkstraat 10, Edegem 2650, Belgium; christiaan.vrints{at}

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The Author's reply Dr Panneerselvam suggests that myocardial perfusion imaging with single photon emission computed tomography (SPECT) or positron emission tomography is a useful tool for risk-stratifying asymptomatic patients with spontaneous coronary artery dissection (SCAD), and that revascularisation is warranted in patients with inducible ischaemia or with viable myocardium in the presence of left ventricular dysfunction.1

With coronary arteriography alone it is impossible to assess accurately the functional significance of non-flow-limiting coronary artery dissections. In those situations, myocardial perfusion imaging can indeed be a very useful method for the functional assessment of coronary artery dissections. However, myocardial …

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