[How dangerous is the dipyridamole test?]

In 203 patients with clinical symptoms of coronary artery disease, cardiac and extracardiac side effects of the dipyridamole test were investigated. Following dipyridamole (0.75 mg/kg body wt. i.v.), heart rate increased significantly, whereas arterial blood pressure remained almost constant. Dyspnea was noted in 80 cases (40.5%). In 48 patients (23.6%) rhythm disturbances were recorded; 58.1% suffered from extracardiac side effects such as congestion in the head, vertigo, heaviness of arms and legs, sensations of heat, upper abdominal pain, and nausea. A detailed report is given of 4 cases with extraordinary symptoms during or after the injection of dipyridamole. A life-threatening status anginosus with dyspnea, ST-segment elevation, and cardiac arrhythmia was observed in one of these cases. High-dose dipyridamole cannot be considered to be harmless. The test should not be performed without continuous ECG monitoring and other safety measures.