|
1
|
Chen Y, Pang ZK, Wang J, Yang RF, Jing R, Chu HX, Hsu B, Lin WH, Li JM. Serial Changes of 99mTc-Sestamibi Washout Due to Coronary Spasm Captured by Dynamic Myocardial Perfusion Imaging With Cardiac Dedicated CZT-SPECT: a Case Report. Circ Cardiovasc Imaging 2022; 15:e013687. [PMID: 35290080 DOI: 10.1161/circimaging.121.013687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Yue Chen
- Department of Nuclear Medicine (Y.C., Z.-k.P., J.W., H.-x.C., J.-m.L.), TEDA International Cardiovascular Hospital, China
| | - Ze-Kun Pang
- Department of Nuclear Medicine (Y.C., Z.-k.P., J.W., H.-x.C., J.-m.L.), TEDA International Cardiovascular Hospital, China
| | - Jiao Wang
- Department of Nuclear Medicine (Y.C., Z.-k.P., J.W., H.-x.C., J.-m.L.), TEDA International Cardiovascular Hospital, China
| | - Rui-Fei Yang
- Department of Cardiology (W.h.L; R.-f.Y., R.J.,.), TEDA International Cardiovascular Hospital, China
| | - Rui Jing
- Department of Cardiology (W.h.L; R.-f.Y., R.J.,.), TEDA International Cardiovascular Hospital, China
| | - Hong-Xin Chu
- Department of Nuclear Medicine (Y.C., Z.-k.P., J.W., H.-x.C., J.-m.L.), TEDA International Cardiovascular Hospital, China
| | - Bailing Hsu
- Nuclear Science and Engineering Institute, University of Missouri-Columbia (B.H.)
| | - Wen-Hua Lin
- Department of Cardiology (W.h.L; R.-f.Y., R.J.,.), TEDA International Cardiovascular Hospital, China
| | - Jian-Ming Li
- Department of Nuclear Medicine (Y.C., Z.-k.P., J.W., H.-x.C., J.-m.L.), TEDA International Cardiovascular Hospital, China
| |
Collapse
|
|
2
|
Abstract
Regadenoson is a pharmacologic stress agent that has been widely adopted as an alternative over other pharmacologic vasodilator agents due to its ease of use, patient tolerance, and safety profile. We report the case of dynamic ST-segment elevation electrocardiogram changes after regadenoson injection during an inpatient single-photon emission computed tomography myocardial perfusion stress test, with subsequent coronary angiography revealing the presence of hemodynamically significant coronary artery disease. Our findings confirm that transient regadenoson-induced ST-segment elevations are a marker for hemodynamically significant disease even in the setting of low-risk SPECT perfusion images.
Collapse
|
|
3
|
Nam JG, Choi SH, Kang BS, Bang MS, Kwon WJ. Development of Coronary Vasospasm during Adenosine-Stress Myocardial Perfusion CT Imaging. Korean J Radiol 2015; 16:673-7. [PMID: 25995700 PMCID: PMC4436000 DOI: 10.3348/kjr.2015.16.3.673] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Accepted: 01/19/2015] [Indexed: 11/15/2022] Open
Abstract
Adenosine is a short-acting coronary vasodilator, and it is widely used during pharmacological stress myocardial perfusion imaging. It has a well-established safety profile, and most of its side effects are known to be mild and transient. Until now, coronary vasospasm has been rarely reported as a side effect of adenosine during or after adenosine stress test. This study reports a case of coronary vasospasm which was documented on stress myocardial perfusion CT imaging during adenosine stress test.
Collapse
Affiliation(s)
- Jeong Gu Nam
- Department of Radiology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan 682-714, Korea
| | - Seong Hoon Choi
- Department of Radiology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan 682-714, Korea
| | - Byeong Seong Kang
- Department of Radiology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan 682-714, Korea
| | - Min Seo Bang
- Department of Radiology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan 682-714, Korea
| | - Woon Jeong Kwon
- Department of Radiology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan 682-714, Korea
| |
Collapse
|
|
4
|
Coronary vasospasm while treating supraventricular tachycardia: is adenosine really to blame? Case Rep Cardiol 2013; 2013:897813. [PMID: 24826297 PMCID: PMC4008346 DOI: 10.1155/2013/897813] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2013] [Accepted: 03/19/2013] [Indexed: 11/20/2022] Open
Abstract
Coronary artery spasm has been reported during adenosine stress testing. Herein, we describe a transient ST-segment elevation following adenosine therapy for supraventricular tachycardia. A 38-year-old male presented to the emergency department with palpitations. Electrocardiogram showed supraventricular tachycardia with short RP interval. Vagal maneuvers were unsuccessful. Adenosine was then administered in two successive injections of 6 and 12 mg dosages, respectively. A subsequent 12-lead electrocardiogram revealed ST-segment elevation in inferior leads with reciprocal changes. Coronary angiography disclosed nonobstructive coronary disease. A postprocedure electrocardiogram exhibited normal sinus rhythm with nonspecific T wave abnormalities. Cardiac biomarkers were elevated with a peak troponin I of 0.32. Echocardiogram depicted bicuspid aortic valve and normal systolic function. Electrophysiological study revealed a concealed left accessory pathway and successful radiofrequency ablation was performed. Given the dynamic changes in the electrocardiogram, we hypothesize that this event was most likely a coronary vasospasm. The mechanism of coronary spasm following adenosine injection remains uncertain. Potential mediators include KATP channels and adenosine-2 receptors.
Collapse
|