By Dr. A.K. Pancholia
MD, FCSI,MNAMS, FIMSA
Case 1 Case 2
Case 1
 50 yrs Male
Hypertensive, non diabetic
Presented with chest pain / ghabrahat/ occasionally increased on exersion
Resting ECG was normal
Subjected to TMT- showed significant ST-T changes in II/III/AVF along with episodes of solvos of multifocal VPBs
 Click on image to see bigger view.
Clinical history and TMT clearly indicate CAD
Confirmed by Coronary angiography ( next)
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Case 2
Another case 44yrs Male
Similar presentation as first case
resting ECG- revealed minor ST depression in II/III/AVF
Subjected to TMT– revealed significant ST-T chages in II/III/ AVF and same solvos of VPBs as in first case (next)
 Click on image to see bigger view.
This patient was also subjected to Coronary angiography
But here CAG is absolutely normal
LV angio revealed moderate Mitral valve prolapse with no MR
 Click on image to see bigger view.
Conclusion
Two different patients with similar presentation, more or less similar resting ECGs and similar changes during TMT with different diagnosis
MVP can present in the same way as CAD
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