Safety of dipyridamole-thallium imaging in high risk patients with known or suspected coronary artery disease.
The effects of an oral dipyridamole suspension were studied in 400 consecutive patients to determine if certain subsets of patients were at greater risk of suffering major complications. Most patients (69%) experienced at least one side effect. Severe chest pain, severe hypotension, and severe dyspnea occurred in 9%, 2.5%, and 0.3% of patients respectively. Two patients were hospitalized for persistent chest pain but none suffered a myocardial infarction, malignant ventricular arrhythmia, or death. The test was found to be safe for patients over 70 yr old. Severe dyspnea was rare even among patients with lung disease who were withdrawn from theophylline prior to testing. Patients with three-vessel coronary artery disease were more likely to experience severe chest pain and those with significant left ventricular dysfunction were more likely to develop severe hypotension. In 99.5% of patients, side effects were promptly reversed by aminophylline. Dipyridamole-thallium imaging has an acceptable safety profile for a wide variety of patients, including those with severe coronary disease and/or left ventricular dysfunction.
Cardiology Division, Stanford University Medical Center, California.
E J
EJ
Perper
G M
GM
Segall
D000367:Age Factors; D006328:Cardiac Catheterization; D002637:Chest Pain / Q000139:chemically induced; D000075202:Contraindications; D003327:Coronary Disease / Q000000981:diagnostic imaging*; D004176:Dipyridamole / Q000009:adverse effects; D004417:Dyspnea / Q000139:chemically induced; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging*; D006801:Humans; D007022:Hypotension / Q000139:chemically induced; D008173:Lung Diseases, Obstructive / Q000150:complications; D008297:Male; D008875:Middle Aged; D011877:Radionuclide Imaging; D012307:Risk Factors; D013794:Thallium Radioisotopes; D016277:Ventricular Function, Left / Q000502:physiology
D013794:Thallium Radioisotopes; D004176:Dipyridamole