BMJ Case Reports 2013; doi:10.1136/bcr-2012-007536
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Ventricular ectopy after exercise and occult ischaemia in a patient with multiple risk factors for ischaemic heart disease and defective anginal warning system

  1. Pietro Sedati2
  1. 1Department of Nuclear Cardiology, Università Campus Bio-Medico, Rome, Italy
  2. 2Department of Radiology, Università Campus Bio-Medico, Roma, Italy
  1. Correspondence to Professor Gian Piero Carboni, g.carboni{at}


In May 2012, a 73-year-old man presented with effort dyspnoea and chest discomfort, negative exercise test for ST depression and ventricular ectopy after exercise. He had a history of Sjögren's syndrome, diabetes, dyslipidemia, hypertension, chronic obstructive pulmonary disease and was under methotrexate treatment for rheumatoid arthritis. Such diseases imply a severe dysfunctional burden, tend to develop accelerated atherosclerosis, endothelial dysfunction and ischaemic heart disease (IHD).1 ,2 A functional assessment was thus provided with an exercise/rest technetium-99 m tetrofosmin-gated …

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