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The utility of cardiopulmonary exercise testing in the assessment of suspected microvascular ischemia

Sundeep Chaudhry, Ross Arena, Karlman Wasserman

    International Journal of Cardiology
    |February 24, 2009
    PubMed

    Insights

    Cardiopulmonary exercise testing (CPET) shows promise for detecting myocardial ischemia. This case report highlights CPET abnormalities in microvascular disease and improvement with ranolazine.

    Area of Science:

    • Cardiology
    • Exercise Physiology

    Background:

    • Emerging evidence suggests cardiopulmonary exercise testing (CPET) can detect myocardial ischemia from macrovascular disease.
    • Microvascular and macrovascular coronary artery disease (CAD) have distinct mechanisms but share exercise-induced left ventricular (LV) dysfunction as a common physiologic effect.

    Observation:

    • This case report details CPET abnormalities in a patient with suspected microvascular CAD.
    • The patient exhibited abnormal LV function during exercise testing.

    Findings:

    • The patient's CPET abnormalities indicated potential myocardial ischemia.
    • Following three weeks of ranolazine treatment, the patient showed improvement in LV function.

    Implications:

    • CPET may offer a valuable tool for diagnosing myocardial ischemia in both macro- and microvascular CAD.
    • Ranolazine demonstrates potential as an effective therapy for improving LV function in patients with microvascular ischemia.

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