Exercise induced atrio-ventricular (AV) block during nuclear perfusion stress testing: a case report

Autor: Antonio Micari, Antonio Castello, Annamaria Martino, Vincenzo Pernice, Paola D’Antoni, Salvatore Accardo, Filippo M. Sarullo
Jazyk: angličtina
Rok vydání: 2016
Předmět:
Pulmonary and Respiratory Medicine
Tachycardia
Atropine
Male
medicine.medical_specialty
exercise stress testing
Heart block
medicine.medical_treatment
Coronary
Ischemia
lcsh:Medicine
Perfusion scanning
Coronary Angiography
Myocardial perfusion imaging
medicine.artery
Internal medicine
Medicine
Humans
cardiovascular diseases
nuclear myocardial perfusion imaging
Angioplasty
Balloon
Coronary
Atrioventricular Block
Tomography
Tomography
Emission-Computed
Single-Photon
medicine.diagnostic_test
business.industry
Angioplasty
lcsh:R
Coronary Stenosis
Percutaneous coronary intervention
Drug-Eluting Stents
Heart
Middle Aged
medicine.disease
Drug-eluting stent
Right coronary artery
Anesthesia
atrio-ventricular block
Cardiology
Exercise Test
Atrio-ventricular block
Exercise stress testing
Nuclear myocardial perfusion imaging
Emission-Computed
medicine.symptom
Cardiology and Cardiovascular Medicine
business
Balloon
Single-Photon
Zdroj: Monaldi Archives for Chest Disease, Vol 70, Iss 1 (2016)
ISSN: 2532-5264
1122-0643
Popis: Background. Exercise causes enhanced sympathetic discharge and results in physiologic tachycardia. However, in some patients with a diseased conduction system resulting from acute ischemia, exercise can precipitate heart block. Methods and results. In this report we describe a 51 years old male patient with transient advanced degree atrioventricular (AV) block developed during recovery from exercise stress testing, resolved after the administration of atropine. Nuclear perfusion imaging demostrated stress-induced ischemia of the inferior-apical segments, and recovery of perfusion in the images obtained at rest. Coronarography showed critical stenosis of the right coronary artery, which was treated by percutaneous coronary intervention (PCI) and drug eluting stent (DES) deployment. Conclusion. Nuclear myocardial perfusion imaging provides noninvasive evidence that transient ischemia of the infero- apical segment can result in advanced degree AV block in patient with critical severe right coronary disease.
Databáze: OpenAIRE
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