Angina pectoris-like pain provoked by intravenous adenosine in healthy volunteers.

Abstract

In a study to characterise the chest pain induced by adenosine this agent was given as a bolus into a peripheral vein to six healthy volunteers (five men) aged 30-44. On the first day the maximum tolerable dose was determined in each case. On the second day three doses of adenosine (one third, two thirds, and the full maximum tolerable dose) and three doses of saline were given single blind in randomised order. Thereafter aminophylline 5 mg/kg was given and the procedure repeated in a different randomised order. On the third day between two thirds and the full maximum tolerable dose was given followed by 10 mg dipyridamole intravenously and a second injection of the same dose of adenosine. Heart rate and atrioventricular blocks were recorded by electrocardiography. One minute after each dose of adenosine the chest pain was scored.The maximum tolerable dose of adenosine ranged from 10-6 to 37-1 mg. All subjects experienced uneasy central chest pain provoking anxiety. The pain radiated to the shoulders, ulnar aspect ofthe arms, epigastric area, back, and into the throat. The pain began about 20 seconds after the injection and lasted 10-15 seconds. Increasing the dose of adenosine increased the intensity of the pain. Administration of aminophylline reduced the pain significantly. Second degree heart block was recorded in

Adenosine causes transient dilatation of coronary arteries in man.

“…Transient retrosternal chest pain was experienced by nine of the 10 patients, as previously described (Watt & Routledge, 1985;Sylven et al, 1986). This angina-like pain was shown in the present study to be associated with an increase in coronary flow.…”

Silent Myocardial Ischemia

“…If a chemical pain stimulus is involved, the substance that has been most recently linked to the production of angina-like chest pain is adenosine. Sylven et al 1 observed that an adenosine infusion resulted in chest pain even in patients without obstructive coronary artery disease. Subsequently, they gave varying amounts to healthy volunteers and caused dose-dependent chest pain in all of the volunteers.…”

Adenosine and amrinone reverse felypressin-induced depression of myocardial tissue oxygen tension in dogs

“…30,31 Adenosine triphosphate and AM were effective in reversing the reductions in CBF, CI and int-PmO 2 induced by felypressin. Although ATP appears to have the advantage of allowing fine adjustments in dosage, it sometimes induces chest pain 32 and may be problematic for use in conscious patients. Amrinone appears to provide the favourable combination of cardiotonic effect, reduction of myocardial oxygen demand and increase in oxygen supply.…”