Use of the epinephrine test in diagnosis of coronary artery disease.
Two-dimensional echocardiographic (2-D echo) and electrocardiographic (ECG) monitoring was performed in 53 patients with anginal chest pain during infusion of physiologic doses of epinephrine. Technically adequate 2-D echo studies were recorded in 45 patients. Of these 45 patients, 35 had significant coronary artery disease. Twenty-two patients showed ECG changes during the test (ECG sensitivity 63%), 13 of whom also showed wall motion abnormalities (2-D echo sensitivity 48.5%). Combined ECG and 2-D echo criteria of a positive test yielded a sensitivity of 74%. None of the 10 patients without coronary artery disease had electrical or mechanical abnormalities during the test (specificity 100%). Thus, the epinephrine test during simultaneous 2-D echo and ECG monitoring is a valid alternative to echocardiographic exercise stress testing. Furthermore, the adequate images obtained during the infusion allow better investigation of relation between wall motion abnormalities and ECG changes during myocardial ischemia.
D000328:Adult; D001145:Arrhythmias, Cardiac / Q000139:chemically induced; D003327:Coronary Disease / Q000175:diagnosis* / Q000503:physiopathology; D004452:Echocardiography; D004562:Electrocardiography; D004837:Epinephrine / Q000009:adverse effects; D005260:Female; D006352:Heart Ventricles / Q000503:physiopathology; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
D004837:Epinephrine