Exercise-induced cardiac ischemia

Case contributed by Dr Jayanth Keshavamurthy

Presentation

Classic symptoms of angina. Normal cardiac troponins.

Patient Data

Age: 55 years
Gender: Male

ST-T wave mildly elevated in anterior leads with reciprocal changes in the inferior leads. Referred for exercise nuclear stress test.

Nuclear medicine

Large reversible ischemia in the septal and anterior wall corresponding to the LAD territory. Slightly reduced systolic function. Summated stress score was 16 (abnormal).

Findings are compatible with stress-induced reversible ischemia secondary to LAD stenosis. 

Case Discussion

A typical case of exercise-induced, reversible myocardial ischemia in the anterior and septal segment of the left ventricle corresponding to the LAD territory.

Proximal and mid-left anterior descending artery stenosis was confirmed on invasive coronary angiography and successfully treated with two coronary stents.

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