NEGATIVE TREADMILL EXERCISE TEST RESULT WITH SUBSEQUENT MYOCARDIAL INFARCTION AND CORONARY ARTERY BYPASS: CASE REPORT.

Myocardial infarction is a rare complication of maximal exercise testing.(1) In the case presented here, infarction occurred in a 54-year-old man, 14 minutes after he showed a normal response to maximal multistage treadmill exercise testing. The presence of coronary artery disease had been documented angiographically prior to exercise testing. After infarction, the patient underwent emergency double aortocoronary bypass to the left anterior descending and right coronary arteries with good results. Clinical evidence suggests that the extent of myocardial necrosis was reduced by timely surgical intervention. There is no conclusive explanation for this patient's normal response to maximal exercise testing in the presence of advanced coronary artery occlusive disease followed rapidly by infarction. The value of exercise testing is well established in assessing the existence or severity of coronary artery disease; a normal response, however, cannot be used as an infallible indication that critical coronary artery disease does not exist.