Cardiologists today rely on stress testing to provide valuable diagnostic information about their patients. How and why can it cross the line to become a trigger for acute coronary events? Is patient selection important to avoid complications? Follow this patient through his stress test.
Exercise Test/adverse effects , Myocardial Infarction/etiology , Electrocardiography , Humans , Male , Middle Aged , Tomography, Emission-Computed, Single-Photon
Recent reports of myocardial infarctions in young persons infected with human immunodeficiency virus (HIV) who are receiving protease inhibitor therapy have raised concerns about premature coronary artery disease in this population. Endothelial dysfunction, hypercoagulability, hypertriglyceridemia, and abnormal coronary artery pathology were in fact associated with HIV infection prior to the availability of protease inhibitor therapy. Newly recognized risk factors, such as insulin resistance, hypercholesterolemia, and fat redistribution syndrome, may exacerbate underlying atherosclerotic risk for patients receiving protease inhibitors. Data on the incidence of myocardial infarction among these patients are largely limited to case reports but are of concern. Pending the availability of further data, it is prudent to monitor these patients for hyperlipidemia and consider interventions to modify cardiac risk factors.
Coronary Disease/pathology , HIV Infections/complications , Adult , Coronary Disease/complications , Female , HIV/drug effects , HIV Infections/drug therapy , HIV Infections/virology , Humans , Male , Middle Aged , Protease Inhibitors/therapeutic use
