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Abnormal stress echocardiography results after coronary stenting
1Heart Institute of St Francis Medical Center, Trenton, New Jersey 08629, USA.
Insights
Stress echocardiograms may show false-positive ischemia in stented coronary arteries. This finding suggests potential overdiagnosis of restenosis after coronary stenting procedures.
Area of Science:
- Cardiology
- Diagnostic Imaging
- Interventional Cardiology
Background:
- Coronary artery stenting is a common procedure to treat blocked arteries.
- Stress echocardiography is frequently used to assess myocardial perfusion and detect ischemia.
Observation:
- A patient with a new stent showed stress-induced ischemia in the stented vessel's territory on echocardiogram.
- Coronary angiography revealed the stent was widely patent, contradicting the echocardiogram findings.
Findings:
- A review of 21 patients within 6 weeks of stenting identified 3 additional cases with false-positive stress echocardiogram results in the stented artery territory.
- This indicates a potential for false-positive ischemia detection by stress echocardiography post-stenting.
Implications:
- These findings question the reliability of stress echocardiography for diagnosing restenosis in the early period after coronary stenting.
- Further research is needed to understand and potentially mitigate these false-positive results.
- Clinical decisions regarding restenosis should consider the possibility of false-positive stress echocardiograms in this specific patient group.
Abstract:
In a patient with a recently placed stent, a stress echocardiogram clearly indicated ischemia in the territory of the stented vessel. Subsequent coronary angiography, undertaken because of presumed restenosis, showed the stented area to be widely patent. This prompted a review of stress echocardiograms performed in patients within 6 weeks of coronary stenting. Of 21 such cases, 3 additional patients were found to have false-positive results in the territory served by the stented vessel.