Posterior Descending Artery Arising from Septal Perforator Causes Angina in an Otherwise Healthy 20-Year-Old Man

摘要

A20-year-old man presented with exertional substernal chest pain. His electrocardiogramshowed evidence of left ventricular (LV) hypertrophy (Fig. 1).His medical history and serial troponin results were not noteworthy. Atransthoracic echocardiogram revealed an LV ejection fraction of 0.59 with mild LVhypertrophy. The patient underwent a nuclear exercise stress test with myocardial perfusionimaging. The technetium-99m single-photon emission computed tomographic(SPECT) scan revealed ischemia in the mid anteroseptal and inferior septal segmentsof the LV.