Korean J Radiol.  2015 Jun;16(3):673-677. 10.3348/kjr.2015.16.3.673.

Development of Coronary Vasospasm during Adenosine-Stress Myocardial Perfusion CT Imaging

• Nam JG
• Choi SH
• Kang BS
• Bang MS
• Kwon WJ

• KMID: 2155540
• DOI: http://doi.org/10.3348/kjr.2015.16.3.673

Abstract

Adenosine is a short-acting coronary vasodilator, and it is widely used during pharmacological stress myocardial perfusion imaging. It has a well-established safety profile, and most of its side effects are known to be mild and transient. Until now, coronary vasospasm has been rarely reported as a side effect of adenosine during or after adenosine stress test. This study reports a case of coronary vasospasm which was documented on stress myocardial perfusion CT imaging during adenosine stress test.

Keyword

Adenosine; Coronary vasospasm; Myocardial perfusion CT

MeSH Terms

Adenosine/*adverse effects/metabolism
Aged
Coronary Vasospasm/*chemically induced/pathology
Humans
Male
Myocardial Perfusion Imaging/*methods
Sensitivity and Specificity
Tomography, X-Ray Computed/*methods
Vasodilator Agents/*adverse effects/metabolism
Adenosine
Vasodilator Agents

Figure

• 

  Fig. 1 73-year-old man presenting with chest pain. Stress and rest myocardial perfusion CT images. A. Stress perfusion CT images in short-axis view showed mild to moderate subendocardial perfusion defect in mid to basal inferior and inferoseptal walls of left ventricle (arrows). B. Rest perfusion CT images in short-axis view showed increased extent of myocardial perfusion defect in mid to basal inferior, inferoseptal, and inferolateral walls of left ventricle (arrows). Stress CT angiography. Curved multiplanar reformatted images of RCA (C) and LCX (D) during stress showed tight stenosis of distal RCA (arrow in C) and no significant stenosis of distal LCX. Note stepping artifact in LCX (arrow in D). Rest CT angiography. Curved multiplanar reformatted images of RCA (E) and LCX (F) at rest demonstrated increased extent of segmental occlusion of distal RCA (arrows in E), and newly developed segmental occlusion of distal LCX (arrows in F). LCX = left circumflex artery, RCA = right coronary artery Conventional coronary angiography showed focal tight stenosis (arrow) in distal RCA (G) and mild stenosis in distal LCX (H). LCX = left circumflex artery, RCA = right coronary artery

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