Case 25

Published on 02/03/2015 by admin

Filed under Internal Medicine

Last modified 03/03/2015

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Case 25

A 42-year-old male with hypertension and end-stage renal disease complains of chest pain. Medications: hydrochlorothiazide, amlodipine, metoprolol, clonidine, and hydralazine.

A 5-minute adenosine infusion stress test was performed. ^99mTc-sestamibi was used for stress and rest images are shown next. His heart rate changed from 71 to 87 beats/min and blood pressure from 183/87 to 206/85 mm Hg. There was no chest pain. ECG showed normal sinus rhythm, generalized nonspecific ST-T changes, and no further change with adenosine infusion.

(Fig. 1a)

(Video 1a)

(Video 1b)

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