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Sudden cardiac death one hour after a negative exercise test. Coronary angiographic follow-up
1Department of Medicine, Brookdale Hospital Medical Center, Brooklyn 11212.
Chest
|October 1, 1988
Insights
A man experienced ventricular fibrillation and a large anterior myocardial infarction shortly after a negative exercise stress test. This suggests a previously undetected coronary artery lesion may have suddenly occluded, causing the heart attack.
Area of Science:
- Cardiology
- Clinical Medicine
- Pathophysiology
Background:
- Exercise stress testing is a common diagnostic tool for coronary artery disease.
- Myocardial infarction (MI) can occur despite a negative stress test.
- Ventricular fibrillation (VF) is a life-threatening cardiac arrhythmia.
Observation:
- A 58-year-old male presented with VF and a large anterior MI.
- These events occurred one hour after a negative exercise test.
- Coronary angiography revealed a "complicated" coronary lesion post-infarction.
Findings:
- The findings suggest sudden occlusion of a previously non-significant coronary lesion.
- This occlusion led to acute myocardial infarction and subsequent ventricular fibrillation.
- The case highlights a potential limitation of exercise testing in specific scenarios.
Implications:
- This case underscores the importance of considering "complicated" coronary lesions.
- It raises awareness about the possibility of acute coronary events post-negative stress tests.
- Further research may be needed to identify risk factors for such events.
Abstract:
A 58-year-old man developed ventricular fibrillation and a large anterior infarction one hour after a negative exercise test. Coronary angiography post-infarction suggested the presence of a "complicated" lesion, raising the possibility that the infarction resulted from sudden occlusion of a previously nonsignificant lesion.