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Intermittent ST-segment depressions during adenosine stress test

Bernies van der Hiel1, Arthur J H A Scholte, Marcel P M Stokkel

  • 1Department of Nuclear Medicine, Leiden University Medical Center, Leiden, The Netherlands.

Clinical Nuclear Medicine
|November 22, 2007
PubMed

Insights

ST-segment depression during adenosine stress tests typically indicates severe 3-vessel disease. This case report highlights intermittent ST depression, possibly caused by coronary spasm, in a patient with this condition.

Area of Science:

  • Cardiology
  • Diagnostic Testing
  • Ischemic Heart Disease

Background:

  • ST-segment depression during myocardial perfusion stress testing often signifies significant coronary artery disease.
  • Adenosine stress testing is a common method for evaluating myocardial ischemia.

Observation:

  • A case report details a patient with severe 3-vessel disease experiencing intermittent ST-segment depression.
  • These electrocardiogram changes occurred during an adenosine stress test.

Findings:

  • The intermittent nature of the ST-segment depression was unusual.
  • Coronary artery spasm induced by adenosine is proposed as the explanation.

Implications:

  • This case suggests coronary spasm should be considered in the differential diagnosis of intermittent ST depression during adenosine stress tests.
  • Further investigation into adenosine-induced coronary spasm in severe 3-vessel disease may be warranted.

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