SPECT may also be used to determine viability of tissue, and whether areas of ischemia are inducible.Medical societies and professional guidelines recommend that the physician confirm a person is at high risk for Chronic Coronary Syndrome before conducting diagnostic non-invasive imaging tests to make a diagnosis, as such tests are unlikely to change management and result in increased costs. Patients who have a normal ECG and who are able to exercise, for example, most likely do not merit routine imaging. Differential diagnosis
There are many causes of chest pain, which can originate from the heart, lungs, gastrointestinal tract, aorta, and other muscles, bones and nerves surrounding the chest. In addition to myocardial infarction, other causes include angina, insufficient blood supply (ischemia) to the heart muscles without evidence of cell death, gastroesophageal reflux disease; pulmonary embolism, tumors of the lungs, pneumonia, rib fracture, costochondritis, heart failure and other musculoskeletal injuries. Rarer severe differential diagnoses include aortic dissection, esophageal rupture, tension pneumothorax, and pericardial effusion causing cardiac tamponade. The chest pain in an MI may mimic heartburn. Causes of sudden-onset breathlessness generally involve the lungs or heart – including pulmonary edema, pneumonia, allergic reactions and asthma, and pulmonary embolus, acute respiratory distress syndrome and metabolic acidosis. There are many different causes of fatigue, and myocardial infarction is not a common cause.
Hotels in Jamaica release much more wastewater than a city. The tourists generate a lot of waste that ends up in the coastal water. The indirect effect of ecotourism in Jamaica is that many people migrated to the town near the natural site because of the more job opportunities due to construction increase, resulting in destroying the environment. South Africa is one of the countries that is reaping significant economic benefits from ecotourism, but the negative effects far outweigh the positive—including forcing people to leave their homes, gross violations of fundamental rights, and environmental hazards—far outweigh the medium-term economic benefits. A tremendous amount of money and human resources continue to be used for ecotourism despite unsuccessful outcomes, and even more, money is put into public relation campaigns to dilute the effects of criticism. Ecotourism channels resources away from other projects that could contribute more sustainable and realistic solutions to pressing social and environmental problems. "The money tourism can generate often ties parks and managements to ecotourism". But there is a tension in this relationship because ecotourism often causes conflict and changes in land-use rights, fails to deliver promises of community-level benefits, damages environments, and has many other social impacts. Indeed, many argue repeatedly that ecotourism is neither ecologically nor socially beneficial, yet it persists as a strategy for conservation and development due to the large profits. While several studies are being done on ways to improve the ecotourism structure, some argue that these examples provide a rationale for stopping it altogether.