Screening cerebrovascular patients for silent myocardial ischemia with stress testing and ambulatory left ventricular function monitor.
Patients with symptomatic cerebrovascular disease suffer a high mortality from myocardial ischemia, which may occur during rest or following the conclusion of exercise. In a pilot study, we screened 11 patients with transient cerebral ischemic attack or stroke for silent myocardial ischemia using bicycle ergometer stress testing with electrocardiographic (EKG) monitoring and ambulatory left ventricular function monitoring (VEST). Three of 11 patients had nondiagnostic exercise EKGs due to failure to achieve their target heart rates during exercise but had positive VEST tests during and after exercise. One patient was falsely positive. VEST may be useful in combination with stress EKG for the detection of silent myocardial ischemia in cerebrovascular patients, but further assessment of the sensitivity and specificity in this patient population needs to be accomplished.
From the Department of Neurology, University of Kansas School of Medicine, Kansas City, KS, U.S.A.
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Jacobs
The Department of Medicine, University of Kansas School of Medicine, Kansas City, KS, U.S.A.
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Lawhorn
From the Department of Neurology, University of Kansas School of Medicine, Kansas City, KS, U.S.A.
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Ziegler
The Department of Medicine, University of Kansas School of Medicine, Kansas City, KS, U.S.A.
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DB
Wilson
The Department of Medicine, University of Kansas School of Medicine, Kansas City, KS, U.S.A.
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Haffey
The Department of Diagnostic Radiology, University of Kansas School of Medicine, Kansas City, KS, U.S.A.
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Baxter
The Department of Diagnostic Radiology, University of Kansas School of Medicine, Kansas City, KS, U.S.A.
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Robinson