Mitsuo K, Degawa T, Tohma M, Nakamura S, Ui K, Nakamura M, Yoshimura H, Watanabe S, Hase H, Ninomiya K
Third Department of Internal Medicine, Toho University, School of Medicine.
Kokyu To Junkan. 1990 Aug;38(8):805-10.
We presented two cases of acute coronary occlusion after successful percutaneous transluminal coronary angioplasty (PTCA) associated with a treadmill stress testing. Case 1: A 54-year-old man with effort angina was referred to our hospital for cardiac catheterization. At the time of cardiac catheterization, the proximal RCA had a 99% diameter narrowing, and the proximal LCX had a 90% diameter narrowing. PTCA was performed and both lesions were successfully dilated. Eight days after PTCA, he had a symptom-limited treadmill stress testing, using the Bruce protocol. The exercise was terminated at a peak heart rate of 173/min (103% of aged-predicted maximal heart rate), and at a maximal systolic blood pressure of 140 mmHg. A few minutes after the end of exercise, he developed a severe chest pain and ECG changes, which showed ST elevation in leads II, III, aVF and ST depression in leads V4-V6. Emergency coronary angiography disclosed an acute coronary occlusion of RCA at the site of PTCA. Emergency PTCA was performed and the lesion was successfully re-dilated. Case 2: A 68-year-old man was referred to our hospital for cardiac catheterization a month after subendocardial anterior myocardial infarction. At the time of cardiac catheterization, the proximal LAD have a 99% diameter narrowing. PTCA was performed and the lesion was successfully dilated. 18 days after PTCA, he had a symptom-limited treadmill stress testing, using the Bruce protocol. The exercise was terminated at a peak heart rate of 158/min (102% of aged-predicted maximal heart rate), and at a maximal systolic blood pressure of 218 mmHg. Ten minutes after the one of 218 mmHg.(ABSTRACT TRUNCATED AT 250 WORDS)
我们报告了两例成功进行经皮腔内冠状动脉成形术（PTCA）后与平板运动负荷试验相关的急性冠状动脉闭塞病例。病例1：一名54岁劳力性心绞痛男性因心脏导管检查转诊至我院。心脏导管检查时，右冠状动脉近端直径狭窄99%，左回旋支近端直径狭窄90%。进行了PTCA，两处病变均成功扩张。PTCA术后8天，他使用布鲁斯方案进行了症状限制性平板运动负荷试验。运动在心率峰值173次/分钟（为年龄预测最大心率的103%）和收缩压最大值140 mmHg时终止。运动结束几分钟后，他出现严重胸痛和心电图改变，表现为II、III、aVF导联ST段抬高，V4-V6导联ST段压低。急诊冠状动脉造影显示PTCA部位右冠状动脉急性闭塞。进行了急诊PTCA，病变成功再次扩张。病例2：一名68岁男性在心内膜下前壁心肌梗死后一个月因心脏导管检查转诊至我院。心脏导管检查时，左前降支近端直径狭窄99%。进行了PTCA，病变成功扩张。PTCA术后18天，他使用布鲁斯方案进行了症状限制性平板运动负荷试验。运动在心率峰值158次/分钟（为年龄预测最大心率的102%）和收缩压最大值218 mmHg时终止。在收缩压达到218 mmHg后的10分钟（摘要截断于250字）
