Mechanisms of myocardial ischemia in a patient with left main coronary artery atresia.
This report describes the different clinical and instrumental manifestations of coronary ischemia in a patient with left main coronary artery atresia. Exercise test and thallium-201 perfusion scintigraphy during isometric exercise test were negative for angina and electrocardiographic changes. Conversely, dipyridamole infusion caused severe angina, marked ST-segment changes and diffuse thallium-201 uptake abnormalities. This peculiar anatomical condition offers the opportunity of high-lighting the role played by the microcirculation in determining myocardial ischemia.
De Paulis
R
R
Division of Cardiac Surgery, Tor Vergata University of Rome, Italy. depauli@tin.it
Gaspardone
A
A
Coppi
G
G
Colagrande
L
L
Nudi
F
F
Chiariello
L
L
D000328:Adult; D000787:Angina Pectoris / Q000175:diagnosis / Q000503:physiopathology; D003097:Collateral Circulation; D017023:Coronary Angiography; D003326:Coronary Circulation; D003330:Coronary Vessel Anomalies / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology; D004176:Dipyridamole; D004562:Electrocardiography; D015716:Electrocardiography, Ambulatory; D005080:Exercise Test; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008833:Microcirculation; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D011877:Radionuclide Imaging; D013794:Thallium Radioisotopes; D014665:Vasodilator Agents
D013794:Thallium Radioisotopes; D014665:Vasodilator Agents; D004176:Dipyridamole