Cantwell J D, Murray P M, Thomas R J
Georgia Baptist Medical Center, Atlanta.
Chest. 1988 Jun;93(6):1264-9. doi: 10.1378/chest.93.6.1264.
Severe cardiac events during either exercise testing or cardiac rehabilitation are described in five patients. The three events related to exercise testing involved patients with atypical chest pain which, in retrospect, probably reflected unstable angina pectoris or coronary vasospasm (or both). Prompt coronary angiography with subsequent percutaneous transluminal coronary angioplasty was performed. Two cardiac arrests (one fatal) occurred during participation in cardiac rehabilitation programs. One was caused by primary ventricular fibrillation. Electrophysiologic testing was used in determining the efficacy of the drug. The fatality was due to an acute myocardial infarction. On-site intravenous thrombolytic therapy might prove useful in similar events in the future. Comparisons of surveys published in the 1970s with those in the 1980s show that the mortality and morbidity during exercise testing remain low and that similar rates during cardiac rehabilitation are even lower; however, these cases exemplify that emergency situations can and do arise, necessitating prompt intervention and aggressive subsequent management.
五名患者在运动测试或心脏康复过程中发生了严重心脏事件。与运动测试相关的三起事件涉及有非典型胸痛的患者，事后回想，这可能反映了不稳定型心绞痛或冠状动脉痉挛（或两者皆有）。随后进行了紧急冠状动脉造影及经皮腔内冠状动脉成形术。在参与心脏康复计划期间发生了两起心脏骤停（其中一例致命）。一例是由原发性心室颤动引起的。电生理测试用于确定药物的疗效。死亡是由急性心肌梗死所致。现场静脉溶栓治疗在未来类似事件中可能会证明是有用的。将20世纪70年代发表的调查与80年代的调查进行比较表明，运动测试期间的死亡率和发病率仍然很低，而心脏康复期间的类似比率甚至更低；然而，这些病例表明紧急情况能够而且确实会出现，需要迅速干预及积极的后续处理。
