Coronary arterial spasm during adenosine myocardial perfusion imaging.
Adenosine is widely used as a pharmacologic agent for stress myocardial perfusion imaging. Vasospasm as a side effect of adenosine has been reported a few times in other countries, but it has not been reported in Japan. A 65-year-old woman was admitted to our hospital because of chest pain at rest and during exercise. She underwent myocardial scintigraphy, to rule out myocardial ischemia. After adenosine infusion, she felt chest pain and the electrocardiogram (ECG) showed ST elevation in inferior leads. Adenosine infusion was stopped immediately. Her chest pain resolved, and the ECG reverted to baseline. Perfusion image presented reverse redistribution in inferior segments, and coronary angiography revealed insignificant lesions. Transient ST elevation during adenosine infusion is thought to be due to coronary vasospasm, judging from scintigraphic and angiographic findings.
Nakayama
Masafumi
M
Division of Cardiology, Hachioji Medical Center, Department of Cardiology, Tokyo Medical University, 1163 Tatemachi, Hachioji-shi, Tokyo 193-0988, Japan. nakayama@tokyo-med.ac.jp
Morishima
Takayuki
T
Chikamori
Taishiro
T
Aiga
Mamoru
M
Takazawa
Kenji
K
Yamashina
Akira
A
D000241:Adenosine / Q000009:adverse effects*; D000368:Aged; D002637:Chest Pain / Q000000981:diagnostic imaging; D003329:Coronary Vasospasm / Q000139:chemically induced*; D004562:Electrocardiography; D005260:Female; D006801:Humans; D055414:Myocardial Perfusion Imaging; D013794:Thallium Radioisotopes; D014665:Vasodilator Agents / Q000009:adverse effects*
D013794:Thallium Radioisotopes; D014665:Vasodilator Agents; D000241:Adenosine