An Unusual ECG Finding during Adenosine Stress Myocardial Perfusion Imaging

Area of Science:

• Cardiology
• Nuclear Medicine
• Pharmacology

Background:

• Adenosine is a key pharmacologic stress agent in myocardial perfusion imaging for diagnosing coronary artery disease.
• Its safety profile is well-established, with transient side effects typically related to AV nodal or bronchial smooth muscle stimulation.
• Patients with implanted cardiac devices may present unique challenges during pharmacologic stress testing.

Purpose of the Study:

• To report an unusual electrocardiographic finding during adenosine stress perfusion imaging.
• To discuss the implications of this finding in a patient with a history of pacemaker insertion.
• To contribute to the understanding of adenosine's effects in specific patient populations.

Main Methods:

• Adenosine stress perfusion imaging was performed for the assessment of atypical chest pain.
• Electrocardiographic monitoring was conducted throughout the procedure.
• The patient had a history of single-chamber pacemaker implantation.

Main Results:

• An uncommon electrocardiographic abnormality was observed during adenosine infusion.
• The finding occurred in a patient with a pre-existing pacemaker.
• The significance of this specific electrocardiographic event in this context requires further elucidation.

Conclusions:

• Adenosine stress perfusion imaging can elicit unexpected electrocardiographic responses, particularly in patients with cardiac devices.
• Clinicians should be aware of potential atypical findings beyond standard adenosine side effects.
• This case underscores the importance of comprehensive monitoring during pharmacologic stress testing.