ST-segment elevation in the recovery phase of nuclear exercise stress test with 99mTc-sestamibi in a patient with critical RCA stenosis and subtle systolic dysfunction in speckle tracking imaging

Abstract

An asymptomatic Caucasian male patient underwent coronaryartery disease diagnostics. Standard exercise treadmilltest was inconclusive, and Holter ECG study didn’t show anysignificant abnormalities. Considering the high risk of ischemicheart diseasenuclear exercise stress test was performed,which revealed ST-segment elevation in the recovery phase ofthe treadmill exercise test. Single photon emission computedtomography (SPECT/CT) showed myocardial perfusion abnormalitiesin the inferior and lateral walls of the left ventricle. Furthermore,speckle tracking imaging showed subtle left ventricle dysfunction. Finally critical stenosis in the second segment ofright coronary artery was diagnosed in coronary angiography.