PMC6016272_01
Exercise stress ECGs.. Notes: (A) The patient's baseline ECG. (B) The patient's ECG at peak stress (Bruce protocol) with no acute dynamic changes consistent with ischemia or infarction. (C) The patient's ECG during recovery after exercise treadmill stress test with no ischemic changes.. Abbreviation: ECG, electrocardiogram.
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He was subsequently risk stratified according to Bruce protocol exercise treadmill test, during which he did not report any anginal episodes and achieved 12 minutes and 23 seconds of exercise time with 13.2 metabolic equivalents (METs) and no significant ST-segment deviation. His DTS was calculated at 12, which is considered a low risk for cardiovascular events (Figure 1A-C).
Left coronary artery angiography.. Notes: (A) The white arrow indicates the mid-LMCA 90% stenosis. (B) The white arrow indicates the mid-LMCA 90% stenosis. (C) The white arrow indicates the mid-LMCA 90% stenosis and the black arrow indicates the proximal, diffuse left anterior descending artery 50% stenosis.. Abbreviation: LMCA, left main coronary artery.
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Cardiac catheterization revealed an eccentric, critical mid-left main lesion with 90% stenosis (American College of Cardiology/American Heart Association [ACC/AHA] type C) with a diffuse, proximal left anterior descending artery (LAD) stenosis (Figure 2A-C).