A CASE OF ELECTRIC SILENCE

(NORMAL ELECTROCARDIOGRAM, NORMAL EXERCISE TOLERANCE TEST AND POSITIVE TROPININ-T IN A PATIENT WITH TIGHT LEFT CIRCUMFLEX CORONARY ARTERY DISEASE)

Abstract

This is a case report of a patient with chest pain who had normal non
invasive investigations at various occasions. He was put on anti anginal therapy and advised follow up. More
invasive investigations were not carried out at that time because of negative exercise tolerance test (ETT).
Patient had repeated visits with atypical chest pain and no electrocardiogram (ECG) evidence of ischemia during
pain or during ETT. At one such visits patient was advised Trop-T that turned out to be positive. Coronary
angiogram was advised and that revealed critical disease in his Left circumflex coronary artery (Cx). It was
treated with intra coronary stents, and patient became symptom free. This is one of those cases with normal
ECG during ischemic anginal episodes and normal ECG during exercise induced ischemia.