[An unexpected complication of exercise testing]

A male patient 40 years of age died after diagnostic exercise testing for stable exercise induced angina, which had existed for two months. The ECG prior to the stress was normal and there had been no signs of unstable angina. The exercise test was discontinued at a load of 120 Watts because of angina without significant ECG changes. Subsequently shock developed with widening of the QRS complex. Immediate coronary angiography revealed an occluded main stem of the left coronary artery. Although recanalisation was achieved, the patient died. The risks of exercise testing and the appropriate precautions are discussed. Laboratories for stress testing of patients with suspected coronary diseases should be located in a hospital with facilities for coronary care.