‘Lest We Forget’: A Case Report of an Unusual Complication of Standard Treadmill Exercise Stress Test

Abstract

Ventricular arrhythmia and cardiac arrest are unusual complications of electrocardiogram exercise stress test. This case report presents a 72-year-old gentleman who developed sustained ventricular tachycardia and subsequent cardiac arrest during a standard treadmill exercise stress test on the background of a 2-month history of intermittent atypical thoracic back pain. Interestingly, thoracic back pain recurred with the onset of ventricular tachycardia. Cardiovascular risk factors were significant for being a current smoker and reported ‘impaired glucose tolerance’. Transthoracic echocardiogram showed preserved left ventricular function and multiple regional wall motion abnormalities, which were consistent with multivessel coronary artery disease. Coronary angiography confirmed severe three-vessel disease. He subsequently underwent coronary artery bypass surgery with an uncomplicated recovery. A retrospective review of glucose tests performed 3 years prior was consistent with the diagnosis of diabetes mellitus.