[Totally asymptomatic coronary left main artery critical stenosis: when non-invasive tests are falsely reassuring].
Left main coronary artery severe stenosis is frequently very symptomatic and is considered as a classical contraindication for non-invasive ischemia testing. When performed, those tests usually yield a large area of ischemia associated with a rich symptomatology. We report the case of a 69-year-old completely asymptomatic man in whom both treadmill effort testing and dobutamine stress echocardiography were falsely reassuring as they eliminated significant ischemia despite the presence of a critical stenosis of distal left main artery ultimately confirmed by angiography. Dobutamine 2D strain performed afterwards was pathological and could have corrected the initially reassuring diagnosis.
Hôpital d'Avignon, centre hospitalier d'Avignon, 305, rue Raoul-Follereau, 84902 Avignon cedex 9, France.
F
F
Aboukhoudir
S
S
Rekik
N
N
Salloum
J L
JL
Hirsch
I
I
Aboukhoudir
B
B
Khennine
M
M
Pansieri
D000368:Aged; D058070:Asymptomatic Diseases; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000175:diagnosis*; D003331:Coronary Vessels / Q000000981:diagnostic imaging; D004452:Echocardiography; D025401:Echocardiography, Stress; D004562:Electrocardiography; D005080:Exercise Test; D005188:False Negative Reactions; D053805:Fractional Flow Reserve, Myocardial; D006801:Humans; D008297:Male
Angiography; Coronarographie; Left main stenosis; Stress dobutamine ecography; Sténose du tronc commun; Écocardiographie de stress à la dobutamine