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Dipyridamole test in angina pectoris: diagnostic value and pathophysiological implications

L Tavazzi, M Previtali, J A Salerno

    Cardiology
    |January 1, 1982
    PubMed
    Summary

    The dipyridamole test aids in diagnosing angina pectoris, showing high specificity but lower sensitivity than exercise tests. It effectively identifies ischemia in patients with effort angina, suggesting drug-induced maldistribution of blood flow.

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    Area of Science:

    • Cardiology
    • Diagnostic Imaging
    • Pharmacology

    Background:

    • Angina pectoris diagnosis relies on various stress tests.
    • Dipyridamole's utility in diagnosing angina requires further evaluation.

    Purpose of the Study:

    • To assess the diagnostic value of the dipyridamole test in angina pectoris.
    • To compare dipyridamole test sensitivity and specificity with exercise testing.

    Main Methods:

    • 54 angina pectoris patients and 12 controls underwent intravenous dipyridamole testing (0.75 mg/kg).
    • Electrocardiographic and hemodynamic changes were monitored.
    • Coronary artery stenosis severity was assessed.

    Main Results:

    • The dipyridamole test showed positive electrocardiographic signs of ischemia in 74% of patients with effort angina.

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  • The test was negative in patients with rest-only angina and controls.
  • Sensitivity was lower than exercise testing, but specificity was high.
  • Positive tests correlated with coronary artery disease severity (one-, two-, or three-vessel disease).

    • Conclusions:

    • Dipyridamole test is a specific diagnostic tool for angina pectoris.
    • Ischemia appears secondary to coronary arteriolar dilatation and flow maldistribution.
    • The test is less sensitive than exercise stress testing for detecting angina.