Exercise Left Ventricular Performance in Patients with Chest Pain, Ischemic-Appearing Exercise Electrocardiograms, and Angiographically Normal Coronary Arteries

Publisher Website
Google Scholar
Abstract
Left ventricular performance was evaluated using 1st-pass radionuclide angiocardiography in 31 patients with chest pain, an ischemic-appearing exercise ECG, and angiographically normal coronary arteries at rest and during maximal upright bicycle exercise. 201Tl imaging was done in all patients after treadmill exercise and in selected patients after ergonovine provocation. Resting left ventricular performance was normal in all patients. An abnormal ejection fraction response to exercise was detected in 12 of 31 patients. Regional dysfunction was present during exercise in 4 patients, all of whom had abnormal global responses. Three of these 12 patients and 2 additional patients had exercise-induced 201Tl perfusion defects. In 9 patients who underwent ergonovine testing, there was no suggestion of coronary arterial spasm. Left ventricular dysfunction during exercise, in the presence of normal resting performance, was found in a substantial number of patients with chest pain, an ischemic-appearing exercise ECG, and normal coronary arteries.