Ventricular Tachycardia Induced by Exercise Test as a Predictor of Coronary Artery Disease Development

Abstract

A long-term clinical observation of the patient with ventricular tachycardia induced by exercise test but without myocardial ischemia and coronary artery atherosclerosis based on the results of angiography in the debut of the disease is described. However, arrhythmia reproducibility during stress tests, positive drug tests with nitroglycerin and beta-blocker, results of cardiac positron emission tomography with fatty acids revealed the ischemic genesis of arrhythmias, which was indirectly confirmed by a positive antiarrhythmic effect of the therapy with a metabolic drug (treatment with a beta-blocker was impossible because there was a sinus block). Coronary angiography was performed again after 7 years during the recurrence of ventricular arrhythmia with unstable angina. Stenosis of the left anterior descending artery was revealed. The antiarrhythmic effect of myocardial revascularization was continuously positive. Therefore, ventricular tachycardia induced by exercise test in patients with risk factors even in the absence of clinical and electrocardiographic criteria for myocardial ischemia could be an early debut of coronary artery disease.

Keywords

• coronary artery disease
• ventricular tachycardia
• holter monitoring
• indeterminate exercise test
• metabolic disturbances during myocardial ischemia