Tag: exercise stress test

Research

Rethinking False Positive Exercise Electrocardiographic Stress Tests by Assessing Coronary...

Exercise electrocardiographic stress testing (EST) has historically been validated against the demonstration of obstructive coronary artery disease. However, myocardial ischemia can occur because of coronary microvascular dysfunction (CMD) in the absence of obstructive coronary artery disease.

The aim of this study was to assess the specificity of EST to detect an ischemic substrate against the reference standard of coronary endothelium-independent and endothelium-dependent microvascular function in patients with angina with nonobstructive coronary arteries (ANOCA).

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Research

Treatment of coronary microvascular dysfunction

Contemporary data indicate that patients with signs and symptoms of ischaemia and non-obstructive coronary artery disease (INOCA) often have coronary microvascular dysfunction (CMD) with elevated risk for adverse outcomes. Coronary endothelial (constriction with acetylcholine) and/or microvascular (limited coronary flow reserve with adenosine) dysfunction are well-documented, and extensive non-obstructive atherosclerosis is often present.

Despite these data, patients with INOCA currently remain under-treated, in part, because existing management guidelines do not address this large, mostly female population due to the absence of evidence-based data.

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Real Patient Stories

Don’s story

I consider myself one of the lucky ones.

I was a runner, triathlete, skier, scuba diver, etc. before my problems got severe enough to seek medical help.

Most doctors took my health decline seriously from the start.

Later, it was not uncommon for doctors who were unaware of my athletic endeavours to assume my subsequent lack of fitness was the cause of my condition rather than the result.

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Suzanne’s story

In February 2020, I had a VF cardiac arrest.

My memories start a week after the event when I awoke in ICU.

I was confused and initially unable to move. My family were at my bedside and told me what had happened.

Amazingly, I had survived not only the arrest, but also aspiration pneumonia, sepsis and a stage 3 acute kidney injury requiring dialysis.

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Barbara’s story

I am a 62-year-old retired physician. My story began at age 47.

I was a very busy practicing OB/Gyn physician who was otherwise healthy.

I was on call at the hospital, and it was turning out to be one of the busiest days I had ever experienced as a physician. I was in a medical group that took call for 24 hours straight, most of the time working the entire 24 hours.

Halfway through that 24-hour call, I was in the operating room doing a C/Section on a patient. Halfway through the surgery I began to feel crushing chest pain.

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