Coronary arterial spasm during adenosine myocardial perfusion imaging

• Published in: Journal of cardiology Vol. 53; no. 2; pp. 288 - 292
• Main Authors: Nakayama, Masafumi, MD, Morishima, Takayuki, MD, Chikamori, Taishiro, MD, FJCC, Aiga, Mamoru, MD, Takazawa, Kenji, MD, FJCC, Yamashina, Akira, MD, FJCC
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.04.2009
• Subjects: Adenosine; Adenosine - adverse effects; Aged; Cardiovascular; Chest Pain - diagnostic imaging; Coronary Vasospasm - chemically induced; Electrocardiography; Female; Humans; Myocardial Perfusion Imaging; ST elevation; Thallium Radioisotopes; Vasodilator Agents - adverse effects; Vasospasm; ST elevation; Vasospasm; Adenosine
• ISSN: 0914-5087; 1876-4738
• DOI: 10.1016/j.jjcc.2008.07.017

Summary 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.