Journal of Nuclear Cardiology

, Volume 24, Issue 4, pp 1350–1354 | Cite as

Frequent MUGA testing in a myeloma patient: A case-based ethics discussion

  • Sabha Bhatti
  • Robert C. Hendel
  • Juan Lopez-Mattei
  • Ronald G. Schwartz
  • Gilbert Raff
  • Andrew J. EinsteinEmail author
Original Article

Case Presentation

A 51-year-old African-American male with a history of relapsed refractory IgA lambda myeloma status post stem cell transplant and many salvage therapies was referred to the nuclear cardiology laboratory in June 2015 for equilibrium radionuclide ventriculography (multigated acquisition; MUGA) to evaluate left ventricular function since he was recently started on a new regimen, which includes the mitogen-activated protein kinase kinase inhibitor trametinib, a potentially cardiotoxic chemotherapeutic agent. His diagnosis of multiple myeloma was first made 7 years prior to presentation to the nuclear lab; at that time he had presented with anemia, hypercalcemia, back pain, lytic bone lesions on CT scan, and markedly elevated total protein and low albumin. Bone marrow biopsy confirmed the suspicion of multiple myeloma. He was initially seen at a local office and subsequently referred to a quaternary care center drawing myeloma patients from across the United States and...



Dr Schwartz reports serving on the speakers bureau for Astellas Dr Einstein reports receiving grant support to Columbia University for other research from GE Healthcare, Philips Healthcare, and Toshiba America Medical Systems.

Supplementary material

12350_2016_540_MOESM1_ESM.pptx (200 kb)
Supplementary material 1 (PPTX 200 kb)
12350_2016_540_MOESM2_ESM.mp3 (6.7 mb)
Supplementary material 2 (MP3 6833 kb)


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Copyright information

© American Society of Nuclear Cardiology 2016

Authors and Affiliations

  • Sabha Bhatti
    • 1
  • Robert C. Hendel
    • 2
  • Juan Lopez-Mattei
    • 3
    • 4
  • Ronald G. Schwartz
    • 5
  • Gilbert Raff
    • 6
  • Andrew J. Einstein
    • 7
    • 8
    Email author
  1. 1.Division of Cardiovascular Medicine, Department of Internal MedicineUniversity of Arkansas for Medical SciencesLittle RockUSA
  2. 2.Departments of Medicine and RadiologyUniversity of Miami Miller School of MedicineMiamiUSA
  3. 3.Division of Diagnostic Imaging, Department of Diagnostic RadiologyThe University of Texas MD Anderson Cancer CenterHoustonUSA
  4. 4.Division of Internal Medicine, Department of CardiologyThe University of Texas MD Anderson Cancer CenterHoustonUSA
  5. 5.Cardiology Division, Department of Medicine, Nuclear Medicine Division, Department of Imaging SciencesUniversity of RochesterRochesterUSA
  6. 6.Department of Cardiovascular MedicineWilliam Beaumont HospitalRoyal OakUSA
  7. 7.Department of Medicine, Division of CardiologyColumbia University Medical Center and New York-Presbyterian HospitalNew YorkUSA
  8. 8.Department of RadiologyColumbia University Medical Center and New York-Presbyterian HospitalNew YorkUSA

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