Under the Bridge: Looking for Ischemia in a Patient with Intramyocardial Coronary Artery Course—The Role of the Cardiopulmonary Exercise Test
Articolo
Data di Pubblicazione:
2023
Citazione:
Under the Bridge: Looking for Ischemia in a Patient with Intramyocardial Coronary Artery Course—The Role of the Cardiopulmonary Exercise Test / M. Mapelli, G. Cattadori, E. Salvioni, I. Mattavelli, E. Pestrin, U. Attanasio, D. Magrì, P. Palermo, P. Agostoni. - In: JOURNAL OF CLINICAL MEDICINE. - ISSN 2077-0383. - 12:17(2023), pp. 5764.1-5764.7. [10.3390/jcm12175764]
Abstract:
Many variables obtained during cardiopulmonary exercise test (CPET), including O2
uptake (VO2) versus heart rate (HR, O2-pulse) and work rate (VO2/Watt), provide quantitative
patterns of responses to exercise when left ventricular dysfunction is an effect of myocardial ischemia
(MI). Therefore, CPET offers a unique approach to evaluate exercise-induced MI in the presence of
fixed or dynamic coronary arteries stenosis. In this paper, we examined the case of a 74-year-old
patient presenting with an ischemic CPET and a normal stress cardiac magnetic resonance (CMR)
with dipyridamole. A coronary angiography demonstrated the presence of myocardial bridging
(MB), a well-known congenital coronary anomaly that is able to generate MI during exercise (but not
in provocative testing using coronary artery vasodilators, such as dipyridamole). Despite the good
diagnostic accuracy of the imaging methods (i.e., stress CMR) in MI detection, this case shows that
exercise should be the method of choice in elicit ischemia in specific cases, like MB.
Tipologia IRIS:
01 - Articolo su periodico
Keywords:
cardiopulmonary exercise testing (CPET); myocardial bridging; stress cardiac magnetic resonance; exercise
Elenco autori:
M. Mapelli, G. Cattadori, E. Salvioni, I. Mattavelli, E. Pestrin, U. Attanasio, D. Magrì, P. Palermo, P. Agostoni
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