Key result
Nuclear exercise stress test with 99mTc-sestamibi revealed unusual ST-segment elevation in the recovery phase, which, alongside speckle tracking imaging, led to the diagnosis of critical right coronary artery stenosis.
Case Report (n=1)
No
ST-segment elevation in the recovery phase of an exercise stress test can be indicative of severe coronary artery stenosis, which may be supported by subtle regional systolic dysfunction on speckle tracking imaging.
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Recovery-phase ST elevation may flag severe stenosis in select cases; single report leaves open diagnostic role of nuclear stress plus speckle tracking.
An asymptomatic Caucasian male patient underwent coronaryartery disease diagnostics. Standard exercise treadmilltest was inconclusive, and Holter ECG study didn’t show anysignificant abnormalities. Considering the high risk of ischemicheart diseasenuclear exercise stress test was performed,which revealed ST-segment elevation in the recovery phase ofthe treadmill exercise test. Single photon emission computedtomography (SPECT/CT) showed myocardial perfusion abnormalitiesin the inferior and lateral walls of the left ventricle. Furthermore,speckle tracking imaging showed subtle left ventricle dysfunction. Finally critical stenosis in the second segment ofright coronary artery was diagnosed in coronary angiography.
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Piszczek et al. (2012) conducted a case report in Coronary artery disease (n=1). Nuclear exercise stress test with 99mTc-sestamibi was evaluated on Detection of myocardial ischemia and coronary artery stenosis. Nuclear exercise stress test with 99mTc-sestamibi revealed unusual ST-segment elevation in the recovery phase, which, alongside speckle tracking imaging, led to the diagnosis of critical right coronary artery stenosis.
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