Triple vessel coronary artery disease presenting as a markedly positive stress electrocardiographic test and a negative SPECT-TL scintigram: a case of balanced ischemia.
Triple vessel coronary artery disease presenting as a markedly positive stress electrocardiographic test and a negative SPECT-TL scintigram: a case of balanced ischemia.
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DOI：
10.4081/hi.2011.e22
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发表时间：
2011-09-29
影响因子：
0.2
通讯作者：
Herzog E
中科院分区：
文献类型：
--
作者：
Aziz EF;Javed F;Alviar CL;Herzog E
在心电图阳性的情况下出现假阴性的核负荷试验是一种非常罕见的现象，通常继发于SPECT-TL所评估的心肌节段的平衡缺血。我们报告一位81岁的绝经后女性，她到主治医师处接受为期6周的运动呼吸困难评估，并被转诊至本院进行运动负荷试验，以排除冠状动脉疾病及找出可能的心肌缺血区。静息心电图无明显变化，进行负荷试验评价。患者住进了心脏监护室，成功地进行了冠状动脉旁路移植术。在心电图阳性的情况下出现假阴性的核负荷试验是一种非常罕见的现象，通常继发于SPECT-TL所评估的心肌节段的平衡缺血。接受具有这些特征的负荷测试的患者应该接受仔细的评估，并应采取高度怀疑的态度来进一步诊断冠状动脉疾病。
The presence of false negative nuclear stress test in the settings of positive electrocardiographic changes is a very unusual phenomenon and is usually secondary to balanced ischemia of the myocardial segments evaluated by SPECT-TL. We present a case of an 81-year old post-menopausal female who presented to her primary care physician for evaluation of a 6-week dyspnea on exertion and was referred to our institution for exercise stress test with Thallium SPECT with the objective of ruling out coronary artery disease and identifying possible areas of myocardial ischemia. The resting electrocardiogram was unremarkable and stress test evaluation was made. The patient was admitted to the cardiac care unit and coronary artery bypass grafting was successfully performed. The presence of false negative nuclear stress test in the settings of positive electrocardiographic changes is a very unusual phenomenon and is usually secondary to balanced ischemia of the myocardial segments evaluated by SPECT-TL. Patients undergoing stress tests with these characteristics should undergo careful evaluation and a high level of suspicion should be adopted for further diagnostic assessment of coronary artery disease.