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

https://doi.org/10.20996/1819-6446-2019-15-2-198-203

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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.

About the Authors

A. A. Tatarinova
Almazov National Medical Research Centre
Russian Federation

Anna A. Tatarinova - MD, PhD, Senior Researcher, Research Laboratory of Electrocardiology.

Akkuratova ul. 2, St. Petersburg, 1 97341



E. A. Ryngach
Almazov National Medical Research Centre
Russian Federation

Elena A. Ryngach - MD, Cardiologist.

Akkuratova ul. 2, St. Petersburg, 1 97341



T. V. Treshkur
Almazov National Medical Research Centre
Russian Federation

Tatyana V Treshkur - MD, PhD, Head of Research Laboratory of Electrocardiology.

Akkuratova ul. 2, St. Petersburg, 1 97341



D. V. Ryzhkova
Almazov National Medical Research Centre
Russian Federation

Daria V. Ryzhkova - MD, PhD, Professor, Head of Research Laboratory of Radiology Medicine, Department of Radiology.

Akkuratova ul. 2, St. Petersburg, 1 97341



O. N. Zhdanova
Pavlov First Saint Petersburg State Medical University
Russian Federation

Olga N. Zhdanova - MD, PhD, Associate Professor, Chair of Faculty Therapy with Clinic.

L'va Tolstogo ul. 6-8, St. Petersburg, 1 97022



D. V. Svalov
Pavlov First Saint Petersburg State Medical University
Russian Federation

Denis V. Svalov - 6-th Year Student, Medical Faculty.

L'va Tolstogo ul. 6-8, St. Petersburg, 1 97022



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For citation:


Tatarinova A.A., Ryngach E.A., Treshkur T.V., Ryzhkova D.V., Zhdanova O.N., Svalov D.V. Ventricular Tachycardia Induced by Exercise Test as a Predictor of Coronary Artery Disease Development. Rational Pharmacotherapy in Cardiology. 2019;15(2):198-203. (In Russ.) https://doi.org/10.20996/1819-6446-2019-15-2-198-203

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ISSN 1819-6446 (Print)
ISSN 2225-3653 (Online)