Adenosine induced coronary spasm - a rare presentation.

Area of Science:

• Cardiology
• Pharmacology
• Electrophysiology

Background:

• Adenosine is a widely used pharmacologic agent in cardiology.
• Its applications include myocardial perfusion imaging, antiarrhythmic therapy, and managing no-reflow phenomenon during percutaneous coronary intervention (PCI).
• Coronary artery spasm is a known, albeit infrequent, adverse effect associated with adenosine administration during stress imaging.

Observation:

• This report details a rare complication following adenosine injection.
• The complication manifested as ST segment elevation on electrocardiogram.
• The adenosine was administered for the treatment of supraventricular tachycardia (SVT).

Findings:

• ST segment elevation, indicative of myocardial ischemia or injury, was observed.
• This event occurred as a direct consequence of adenosine administration for SVT.
• The incidence of this specific complication is notably rare.

Implications:

• Clinicians should be aware of the potential for ST segment elevation as a rare adverse effect of adenosine, even when used for indications other than stress testing.
• This finding may necessitate careful electrocardiographic monitoring following adenosine administration for supraventricular tachycardia.
• Further investigation into the mechanisms underlying this rare complication could refine patient management strategies.