Dipyridamole-atropine-induced myocardial infarction in a patient with patent epicardial coronary arteries.
BACKGROUND
The diagnostic accuracy of the physical and pharmacological stress echocardiography tests is higher than routine exercise electrocardiography. They have an acceptable safety profile and have been rarely associated with severe adverse effects.


METHODS
We present a case of acute anterior myocardial reinfarction immediately after exercise and pharmacological (dipyridamole-atropine) stress echocardiography testing 1 month after successful stent implantation in LAD. Our patient was a 43-year-old man with a history of heavy smoking and hypertension. Remarkably, the stress echocardiogram was non-diagnostic few hours before the infarction occurred. Angiography performed 4 months after the reinfarction revealed neither a culprit lesion nor stent thrombosis.


CONCLUSIONS
Aggressive "last generation" pharmacological stress testing may provide optimal diagnostic accuracy, but as in our case, complications may occur, even after negative stress testing. To our knowledge, this is the first reported case of an acute myocardial infarction as a severe complication of stress testing, which developed in a patient after stent implantation.
Nedeljkovic
M A
MA
University Institute for Cardiovascular Diseases, Department for Diagnostic and Catheterization Laboratories, Clinical Center of Serbia, Belgrade, Yugoslavia.
Ostojic
M
M
Beleslin
B
B
Nedeljkovic
I P
IP
Stankovic
G
G
Stojkovic
S
S
Saponjski
J
J
Babic
R
R
Vukcevic
V
V
Ristic
A D
AD
Orlic
D
D
D000328:Adult; D015906:Angioplasty, Balloon, Coronary; D001285:Atropine / Q000009:adverse effects*; D017023:Coronary Angiography; D003327:Coronary Disease / Q000175:diagnosis*; D004176:Dipyridamole / Q000009:adverse effects*; D004452:Echocardiography; D004562:Electrocardiography / Q000187:drug effects; D005080:Exercise Test; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000139:chemically induced* / Q000175:diagnosis / Q000235:genetics / Q000628:therapy; D012008:Recurrence; D012307:Risk Factors; D015607:Stents
D004176:Dipyridamole; D001285:Atropine