Previous PTCS with stents (ADA, Cx) 8 months before. Exerptional dyspnea, no chest pain.
No EKG changes. -Unable to exercise (knee prosthesis).
Myocardial perfusion study (MPI) with dipyridamole.
Teaching points:
Restenosis occurs in approximately one-third of patients undergoing PTCA, one-half of whom presents with symptoms.
Functional imaging performed before 6 months of the procedure can yield false–positive results due to lack of recovery of coronary flow reserve .
Non-invasive imaging is indicated after PTCA if atypical chest pain or other non-specific symptoms appear, or an exercise test is non-diagnostic / equivocal.
Transient ischemic dilation (TID) is frequently related to balanced ischemia, which in turn is associated with multivessel disease.
A drop in post-stress LVEF can reflect myocardial stunning and is related with increased risk of cardiac events.
