Dipyridamole angina: a specific symptom of severe multivessel disease.
BACKGROUND
Several studies have indicated that ischemia induced by dipyridamole is frequently associated with angina or ischemic ST-segment depression and that it occurs mainly in patients with three-vessel disease, those with collateral vessels, or those with both.


METHODS
In order to analyze the diagnostic relationships among them, we studied 227 consecutive patients who underwent coronary angiography and dipyridamole-thallium scintigraphy.


RESULTS
A perfusion defect was found in 134 patients. Of these, 88 patients (66%) showed no significant ECG modifications or angina; 46 (34%) had a transient ST-segment depression, which was associated with typical angina ('dipyridamole angina') in 12. These 12 patients had three-vessel disease with intercoronary collateral circulation. Among the 134 patients with coronary critical stenoses and a positive thallium-dipyridamole test, collateral vessels were detected in 91 (68%).


CONCLUSIONS
Dipyridamole angina, occurring during a positive dipyridamole-thallium test, is usually a manifestation of severe coronary stenoses with collateral circulation. However, as a diagnostic symptom it is characterized by high specificity but low sensitivity.
Dabizzi
P
P
Department of Internal Medicine, University of Florence, Italy.
Barletta
G
G
Lo Sapio
P
P
Del Bene
R
R
Fantini
F
F
D000368:Aged; D000787:Angina Pectoris / Q000000981:diagnostic imaging* / Q000209:etiology; D003097:Collateral Circulation; D017023:Coronary Angiography; D003327:Coronary Disease / Q000175:diagnosis / Q000503:physiopathology; D004176:Dipyridamole; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000175:diagnosis / Q000503:physiopathology; D011877:Radionuclide Imaging; D012680:Sensitivity and Specificity; D013794:Thallium Radioisotopes
D013794:Thallium Radioisotopes; D004176:Dipyridamole