Intermittent left anterior hemiblock during treadmill exercise test. Correlation with coronary arteriogram

Area of Science:

• Cardiology
• Electrophysiology

Background:

• Treadmill exercise tests are standard for assessing cardiac function.
• Left anterior hemiblock is a type of conduction disturbance.
• Coronary artery disease affects blood flow to the heart muscle.

Observation:

• Two patients developed left anterior hemiblock during treadmill tests.
• Cardiac catheterization revealed significant proximal left anterior descending artery obstruction in these patients.

Findings:

• A novel association between exercise-induced left anterior hemiblock and proximal left anterior descending coronary artery disease is reported.
• Successful myocardial revascularization eliminated the conduction disturbance during subsequent treadmill testing.

Implications:

• Exercise-induced left anterior hemiblock may serve as a valuable clinical marker for obstructive coronary artery disease.
• This finding could prompt earlier or more focused diagnostic evaluation in at-risk patients.
• Further research is warranted to validate this association in larger cohorts.