Abstract

TEIXEIRA, Melisa et al. Transient myocardial injury induced by exercise stress testing in a patient evaluated in the Chest Pain Unit. Rev.Urug.Cardiol. [online]. 2024, vol.39, n.1, e704.  Epub Dec 01, 2024. ISSN 0797-0048.  https://doi.org/10.29277/cardio.39.1.14.

The graded exercise test is a low-cost technique that has been used for decades in the diagnostic and prognostic evaluation of coronary artery disease. Signs of subepicardial ischemia and transmural injury induced by exercise, in patients without a history of myocardial infarction, are findings that often indicate significant coronary artery disease. We present the case of a 61-year-old man with a history of progressive angina who, during a graded exercise test performed under a Chest Pain Unit protocol, exhibited a sudden increase in T-wave voltage and ST-segment elevation in precordial leads V2 to V4. Coronary angiography revealed critical stenosis of the left anterior descending artery, requiring percutaneous intervention with the implantation of an everolimus-eluting stent. Based on this case, we review the available literature on these unusual findings during exercise testing, discussing their diagnostic significance and prognostic implications in patients evaluated in the Chest Pain Unit.

Keywords : EXERCISE TEST; TRANSMURAL ISCHEMIA; ELECTROCARDIOGRAPHY.

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