Left main coronary artery stenosis presenting with negative myocardial perfusion imaging: a case report of balanced ischaemia.

ABSTRACT:

Background

Myocardial perfusion imaging (MPI) stress testing using technetium sestamibi is a non-invasive tool for diagnosing and risk-stratifying patients with coronary artery disease. Despite its utility, MPI stress testing exhibits various limitations.

Case summary

An 80-year-old male presented with severe non-radiating exertional epigastric pain. Four months earlier, an MPI test was low risk with no significant perfusion defect. High-sensitivity cardiac troponins peaked at 97 ng/L with a delta value of 25. Left cardiac catheterization revealed a 99% calcified stenosis in the left main coronary artery. The patient underwent emergent coronary artery bypass grafting for refractory angina.

Discussion

A critical left main coronary artery stenosis occurred despite a rec

SUBMITTER: Agyeman WY 

PROVIDER: S-EPMC12570302 | biostudies-literature | 2025 Oct

REPOSITORIES: biostudies-literature