Case 19

Published on 02/03/2015 by admin

Filed under Internal Medicine

Last modified 02/03/2015

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Case 19

A 65-year-old man had abnormalities on his electrocardiogram (ECG) at a routine outpatient office visit with his primary physician. He was referred for exercise stress/rest myocardial perfusion imaging.

He exercised for 9 minutes, 15 seconds, achieving 10 METs with Bruce protocol. His heart rate changed from 55 beats/min to 135 beats/min (achieving 87% target) and blood pressure from 150/70 to 190/90 mm Hg. Resting ECG showed sinus rhythm with left anterior fascicular block and nonspecific ST-T changes in limb leads. No chest pain or ST-segment change occurred on stress. Patient underwent stress-rest 99mTc-sestamibi perfusion imaging.

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(Video 1a)

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