Key result
Treadmill stress testing reproducibly induces RCA vasospasm and ST-elevation that resolves with nitroglycerin.
Case Report (n=1)
No
This case highlights a rare presentation of variant angina with reproducible intermittent ST-segment elevations during both exercise and recovery phases.
Exercise-induced ST elevation may signal coronary vasospasm; leaves open diagnostic role of stress testing in variant angina.
A 59-year-old man was admitted for evaluation of mild exertional angina in the morning. During graded treadmill exercise stress testing, the patient had reproducibly intermittent chest pains associated with ST-segment elevations in leads II, III and aVF. A baseline coronary angiogram showed a coronary narrowing of 90% in the middle segment of the right coronary artery. The coronary narrowing was immediately resolved by an intracoronary injection of nitroglycerin. This was a very rare case of variant angina with intermittent ST-segment elevations and chest pains which were reproducibly demonstrated during exercise and the recovery phase of treadmill testing.
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Inomata et al. (1995) conducted a case report in Exercise-induced variant angina (n=1). Treadmill exercise stress testing was evaluated on Development of chest pain and ST-segment changes. Treadmill exercise stress testing reproducibly induced intermittent chest pain and ST-segment elevation in a 59-year-old man, revealing right coronary artery vasospasm that resolved with nitroglycerin.
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