Author + information
- Received August 22, 2011
- Accepted September 5, 2011
- Published online July 3, 2012.
A 63-year-old man with hypertension, hyperlipidemia, and nicotine abuse underwent an echocardiogram stress test to investigate a recent history of chest pressure at rest. Baseline echocardiogram and electrocardiogram (A) were within normal limits.
At 4 min, 44 s of Bruce protocol, the patient developed shortness of breath with 2-mm down-sloping ST-segment depressions in inferior and lateral leads and 3-mm ST-segment elevation in lead aVR (B). Echocardiographic images during stress showed left ventricular cavity dilation and hypokinesis of septal, anterior, and lateral walls (Online Videos 1 and 2).
At cardiac catheterization, the patient had 50% left main stenosis with thrombus, 99% ostial left anterior descending artery with thrombus, 100% occluded mid-right coronary artery with collaterals (C). The patient was referred for coronary artery bypass grafting. His post-operative course was uncomplicated.
- Received August 22, 2011.
- Accepted September 5, 2011.
- American College of Cardiology Foundation