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Acute coronary thrombotic occlusion following exercise testing 6 weeks after percutaneous transluminal coronary angioplasty.

Exercise stress testing is often performed following percutaneous transluminal coronary angioplasty (PTCA) in order to evaluate the efficacy of the procedure. Together with thallium-201 (Tl-201) scintigraphy, these noninvasive tests provide valuable data for predicting the recurrence of angina and restenosis. However, concerns regarding the safe timing of exercise testing post-PTCA have been raised in 3 previous case reports. Each case documents acute coronary occlusion shortly after stress testing performed within several days of successful angioplasty, leading to the recommendation that such testing be deferred up to 4 weeks following PTCA. This paper reports a patient in whom acute thrombotic occlusion of the left anterior descending coronary artery (LAD) occurred immediately after a mildly abnormal exercise Tl-201 stress test done 6 weeks after PTCA.