Dipyridamole-induced STEMI: case report and review of the literature
Hussam Al Hennawi1, Sunita Lakhani1, Shayan Iqbal Khan1
1Department of Internal Medicine, Jefferson Abington Hospital, Abington, PA, USA.
Insights
Dipyridamole nuclear myocardial perfusion imaging is a safe tool for assessing ischemia, especially in non-exercising patients. Rarely, it can trigger ST-segment elevation myocardial infarction, as seen in a recent case study.
Area of Science:
- Cardiology
- Nuclear Medicine
- Diagnostic Imaging
Background:
- Dipyridamole nuclear myocardial perfusion imaging is a valuable tool for evaluating myocardial ischemia.
- It is the preferred method for cardiac risk stratification in patients unable to perform exercise stress tests.
- Pharmacological stress with dipyridamole induces coronary vasodilation, potentially revealing flow abnormalities in coronary artery disease.
Abstract:
Dipyridamole nuclear myocardial perfusion imaging is a safe and useful modality for assessing myocardial ischemia. It is the modality of choice for cardiac risk stratification in patients who are unable to exercise. Intravenous dipyridamole causes coronary vasodilation and may result in heterogeneity of coronary blood flow in significant coronary artery disease. Ischemic electrocardiographic changes following pharmacological stress testing are less likely to occur compared with exercise stress tests. Ischemia is more likely to be present in the form of ST depression, with ST-segment elevation being exceedingly rare. We present the case of a 73-year-old patient who developed ST-segment elevation myocardial infarction following pharmacologic stress testing.
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