Spontaneous coronary artery dissection in a 50-year-old woman

Taylor Petropoulos; Jasjit Rooprai; Mark A. Kotowycz; Mina Madan

doi:10.1503/cmaj.212009

Submit a Response to This Article

Compose Response

Title *

References

Author Information

Contributors

First Name and Middle Initial *

First or given name, e.g. 'Peter'.

Last Name *

Your last, or family, name, e.g. 'MacMoody'.

Degrees

Email Address *

Your email address, e.g. [email protected]

Occupation *

Your role and/or occupation, e.g. 'Orthopedic Surgeon'. Minimum 7 characters.

Affiliation *

Your organization or institution (if applicable), e.g. 'Royal Free Hospital'. Minimum 12 characters.

Address

Your organization, institution's or residential address.

Statement of Competing Interests

Competing interests? *

Yes

Please describe the competing interests

Vertical Tabs

Jump to comment:

RE: Exercise Stress Test After Acute Myocardiol Infarction Should be Cautiously
Min Tang [M.S.] and Fan Ouyang [M.D.]

Posted on: 16 July 2022

Posted on: (16 July 2022)
Page navigation anchor for RE: Exercise Stress Test After Acute Myocardiol Infarction Should be Cautiously
RE: Exercise Stress Test After Acute Myocardiol Infarction Should be Cautiously
Min Tang [M.S.], Cardiologist, Zhuzhou Central Hospital
Other Contributors:
Fan Ouyang, Cardiologist
We read the paper by Taylor Petropoulos et al. (Apr.19 issue)(1) that describes a patient with myocardial infarction due to spontaneous coronary artery dissection (SCAD). We would like to comment on one issue. The patient underwent exercise stress test during her first hospitalization, with a result came back negative. Exercise stress testing has been used for decades as a noninvasive test to diagnose and risk stratify coronary artery disease (CAD), and it provides significant prognostic information for patients with known coronary artery disease. To the best of our knowledge, exercise stress test is absolutely contraindicated 2 to 3 days after myocardial infarction and is relatively contraindicated when left main coronary stenosis is found.(2,3) In addition, some medications such as beta blockers, calcium-channel blockers and nitrates can lead to false negative result due to they can affect maximal heart rate achieved or can attenuate the angina and ST depression associated with myocardial ischemia.(2,3) We suggest that exercise stress test should be performed with caution after myocardial infarction.
Competing Interests: None declared.
References
Taylor Petropoulos, Jasjit Rooprai, Mark A. Kotowycz,et al.Spontaneous coronary artery dissection in a 50-year-old woman.CMAJ 2022 April 19;194:E549-53.
Kharabsheh SM, Al-Sugair A, Al-Buraiki J, Al-Farhan J. Overview of exercise stress testing. Ann Saudi Med. 2006 Jan-Feb;26(1):1-6. PMID: 16521867.
Vilcant V, Zeltser R. Treadmill Stress Testing. [Updated 2022 May 2]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-.