Reversible Ischemic Neurological Deficit (RIND) due to Exercise Testing for the Diagnosis of Angina Pectoris

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  • Nanke Toshihiko
    Division of Cardiology, St. Marianna University School of Medicine
  • Matsumoto Naoki
    Department of Pharmacology, St. Marianna University School of Medicine
  • Wakimoto Hirofumi
    Division of Cardiology, St. Marianna University School of Medicine
  • Nakazawa Kiyoshi
    Division of Cardiology, St. Marianna University School of Medicine
  • Miyake Fumihiko
    Division of Cardiology, St. Marianna University School of Medicine
  • Watanabe Hirofumi
    Division of Neurology, Department of Internal Medicine, St. Marianna University School of Medicine
  • Horiuchi Masahiro
    Division of Neurology, Department of Internal Medicine, St. Marianna University School of Medicine
  • Takahashi Yoichi
    Division of Neurology, Department of Internal Medicine, St. Marianna University School of Medicine

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Description

A 57 year old Japanese male with chest oppression due to exercise is presented. This symptom was likely due to effort angina pectoris. Master's double two-step test revealed ischemic ST segment depression on the electrocardiogram, thus, a Tl201 myocardial stress imaging test using a bicycle ergometer was undertaken. Immediately following the exercise test, the patient experienced dizziness and palsy in his left upper and lower limbs. Cerebral angiography demonstrated 70% stenosis at the right internal carotid artery, but no abnormal findings were demonstrated on a cranial x-ray CT scan and magnetic resonance imaging. His palsy in the left limbs completely recovered within 3 weeks. Thus this event was diagnosed as a reversible ischemic neurological deficit (RIND). Major but noncardiogenic complications during exercise testing are very rare, and RIND has not been reported thus far to the best of our knowledge. <br>

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