ST Segment Elevation ECG Changes During Pharmacologic Stress With Regadenoson

Abstract

Regadenoson is a pharmacologic stress agent that has been widely adopted as an alternative over other pharmacologic vasodilator agents due to its ease of use, patient tolerance, and safety profile. We report the case of dynamic ST-segment elevation electrocardiogram changes after regadenoson injection during an inpatient single-photon emission computed tomography myocardial perfusion stress test, with subsequent coronary angiography revealing the presence of hemodynamically significant coronary artery disease. Our findings confirm that transient regadenoson-induced ST-segment elevations are a marker for hemodynamically significant disease even in the setting of low-risk SPECT perfusion images.

A case report of dipyridamole stress-induced ST depression progressing to ST-elevation myocardial infarction despite intravenous aminophylline: steal, spasm, or something else?

“…Angiography revealed a non-occlusive but functionally significant LAD stenosis. Interestingly, the post-stress myocardial perfusion images were normal, illustrating that ischaemia did not occur at the time of vasodilator stress and that coronary vasospasm occurred after cessation of the pharmacological effects of the vasodilator 12 . Our patient, however, did not exhibit angiographic evidence of coronary vasospasm despite having ongoing chest discomfort and ST elevation.…”