Non-invasive diagnosis of anomalies of the coronary arteries with the help of stress tests

Abstract

Anomaly of coronary artery muscular bridge (MB) may cause acute coronary syndrome and sudden cardiac death (listed in second place after hypertrophic cardiomyopathy) in young people without risk factors for coronary heart disease. The aim: 1) identification of myocardial ischemia in patients with atypical angina using a modified pharmacological stress echocardiography (MPSE); 2) to compare the informativeness of MPSE and dobutamine stress echocardiography (DSE) in patients with MB identified by coronary angiography (CAG). Material, results: 10298 patients were examined with the help of CAG and 364 patients (3,5 %) found MB. They spent resting ECG, Holter ECG, treedmil, DSE, MPSE with nitroglycerin. Formed 3 groups of patients: 1st gr. - patients with MB (n=32) who had DSE, 2nd gr. - patients with MB (28/32 patients of 1 gr. again), which made MPSE with in combination with NG, 3rd gr. comparison - patients with atherosclerotic stenosis (n=16) who had DSE. In our study stress-induced ischemia was diagnosed in 22 of 32 (69 %) patients with isolated MB to use the standard DSE Protocol. The sensitivity of stress Echocardiography increased by 1.3 times, when dobutamine with nitroglycerin had combine. MPSE was able to revealed ischemic reaction in 26 of 28 patients with isolated MB (93 %)