Rapid Spontaneous Coronary Artery Reperfusion Following Severe Bradycardia During Exercise Tolerance Test: A Rare Case Report

Document Type: Case Report

Authors

1 Cardiologist,Department of Cardiology, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran.

2 Master of Science in Cardiovascular Perfusion, Department of Extra_Corporeal Circulation(ECC), Razavi Hospital, Imam Reza International University, Mashhad, Iran.

Abstract

The acute occlusion of a coronary artery without the evidence of myocardial infarction might immediately affect both the diagnosis and treatment of coronary artery disease. We present the case with a sudden occlusion of the left main coronary artery without typical chest pain following an exercise tolerance test and rapid spontaneous reperfusion of the left main coronary artery.

Keywords


1. Younessi Heravi MA, Yaghubi M, Joharinia S. Effect of change in patient’s bed angles on pain after coronary angiography according to vital signals. J Res Med Sci. 2015; 20:937-43.

2. Younessi Heravi MA, Mojdekanlu M, Seyed Sharifi SH, Yaghubi M. The role of cardiovascular risk factors in involvement of coronary arteries; A predictive model in angiographic study. Journal of North Khorasan University of Medical Sciences. 2014; 6(1): 199-205.

3. Attar A, Mehrzadeh A, Foulad M, Aldavood D, Fallahzadeh MA, Assadian Rad M, et al. Accuracy of exercise tolerance test in the diagnosis of coronary artery disease in patients with left dominant coronary circulation. Indian Heart J. 2017; 69:624-7.

4. Banerjee A, Newman DR, Van den Bruel A, Heneghan C. Diagnostic accuracy of exercise stress testing for coronary artery disease: a systematic review and meta-analysis of prospective studies. Int J Clin Pract. 2012; 66:477-92.

5. Kobayashi S, Yoshida K, Nishimura M, Miyamoto K, Kawakami Y. Paradoxical bradycardia during exercise and hypoxic exposure. The possible direct effect of hypoxia on sinoatrial node activity in humans. Chest. 1992; 102:1893-5.

6. Rüst CA, Knechtle B, Rosemann T. Exercise electrocardiogram testing in two brothers with a different outcome – a case study exercise testing in master cyclists. Int J Gen Med. 2013; 6:495-501.

7. Ovrehus KA, Jensen JK, Mickley HF, Munkholm H, Bøttcher M, Bøtker HE, et al. Comparison of usefulness of exercise testing versus coronary computed tomographic angiography for evaluation of patients suspected of having coronary artery disease. Am J Cardiol. 2010; 105:773-9.

8. Lin CF, Cheng SM. Symptomatic bradycardia due to total occlusion of the left circumflex artery without electrocardiographic evidence of myocardial infarction at initial presentation. Tex Heart Inst J. 2006; 33:396-8.

9. Parent ME, Lepage S. A heart stopping case of the Bezold-Jarisch reflex. Case Rep Cardiol. 2015; 2015:359401.

10. Vasheghani-Farahani A, Kassaian SE, Yaminisharif A, Davoodi G, Salarifar M, Amirzadegan A, et al. The association between coronary arterial dominancy and extent of coronary artery disease in angiography and paraclinical studies. Clin Anat. 2008; 21:519-23.

11. Gupta T, Saini A, Sahni D. Terminal branching pattern of the right coronary artery in left-dominant hearts: a cadaveric study. Cardiovasc Pathol. 2013; 22:179-82.