Gangasani S R, Frumin H, Safian R D, O'Neill W W, Franklin B A
William Beaumont Hospital, Division of Cardiology, Royal Oak, MI, USA.
Chest. 2000 Jul;118(1):249-52. doi: 10.1378/chest.118.1.249.
We report a case of a marathon runner who presented with chest tightness, ST-segment depression, and ventricular fibrillation following treadmill exercise testing. At cardiac catheterization, the patient was found to have an isolated lesion in the left anterior descending (LAD) artery that was hemodynamically insignificant by accepted angiographic and coronary flow reserve standards. Ventricular fibrillation was thought to be idiopathic, and an implantable cardioverter defibrillator was placed. Chest pain and ST-segment depression followed by ventricular fibrillation was reproduced during follow-up treadmill testing, prompting reconsideration of the original diagnostic hypothesis. A coronary stent was deployed in the LAD artery. The patient has been asymptomatic and arrhythmia free during follow-up treadmill testing and recreational running.
我们报告一例马拉松运动员，其在跑步机运动试验后出现胸闷、ST段压低和室颤。在心脏导管插入术中，发现该患者左前降支（LAD）动脉存在孤立病变，按照公认的血管造影和冠状动脉血流储备标准，该病变在血流动力学上无显著意义。室颤被认为是特发性的，遂植入了植入式心脏复律除颤器。在后续的跑步机测试中再次出现胸痛、ST段压低并随后发生室颤，这促使重新考虑最初的诊断假设。于是在LAD动脉中植入了冠状动脉支架。在后续的跑步机测试和休闲跑步期间，该患者一直无症状且未发生心律失常。
