Use of Pharmaceuticals in Noninvasive Cardiovascular Diagnosis

Meisner, J.; Shirani, Jamshid; Alaeddini, Jamshid; Frishman, William H.

doi:10.1097/00132580-200209000-00008

Cited by 5 publications

(3 citation statements)

References 218 publications

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“…Its safety profile is well established and most of its side effects are mild and transient [9,10]. Because of its short half-life (\10 s), most of its side effects, such as flushing, chest pain, nausea, and even serious adverse events, including bronchospasm, hypotension and bradycardia, can resolve soon after discontinuation of adenosine infusion [11,12].…”

Section: Discussionmentioning

confidence: 99%

Coronary spasm after completion of adenosine pharmacologic stress test

et al. 2011

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Adenosine is a frequently used pharmacologic stress agent in myocardial perfusion imaging. Its safety profile is well established, and most of its side effects are mild and transient. Coronary vasospasm occurs occasionally during or after adenosine stress test in rare cases, which may lead to seriously adverse outcomes. This study reported 3 such cases after completion of adenosine pharmacologic stress test.

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Section: Discussionmentioning

confidence: 99%

Coronary spasm after completion of adenosine pharmacologic stress test

et al. 2011

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“…Another class of pharmaceuticals used for stress testing are sympathomimetic agents, which simulate the effects of exercise on the heart, increase myocardial contractility and heart rate and dilate peripheral vasculature (35). Dobutamine is used in patients with limited exercise capacity, the elderly, or in patients with a contraindication for vasodilator stress testing.…”

Section: Pharmacological Stress Protocolsmentioning

confidence: 99%

Cardiac Imaging in Acute Coronary Syndromes and Acute Myocardial Infarction – An Update

2006

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Summary Myocardial perfusion imaging (MPI) using nuclear techniques is a well‐established diagnostic tool in the management of patients after acute coronary syndromes (ACS) or acute myocardial infarction (AMI) providing non‐invasively information about perfusion and function. Single photon emission computed tomography (SPECT) is routinely applied for MPI allowing the characterization of localization, extent and severity of perfusion abnormalities. Gated SPECT MPI is a technique that can accurately define the individual patient risk among clinically stable survivors of AMI, assessing the total left ventricular (LV) perfusion defect size, the extent of inducible ischaemia and the degree of LV dysfunction. The documented prognostic value of these scintigraphic parameters is of clinical importance to guide decision making in the cardiac patient. Moreover, the cost effectiveness of implemented MPI in the work‐up of patients after AMI has been demonstrated. Metabolic imaging with F‐18 deoxyglucose positron emission tomography (PET) is currently the most advanced scintigraphic imaging technique developed for in vivo assessment of tissue viability, providing clinical valuable information about the presence and extent of viable myocardium in patients with coronary artery disease. Whether this technique will be valuable for patients with ACS or AMI has not been established, yet. However, PET technology offers fascinating opportunities to investigate the distinct pathophysiological pathways in acute and chronic cardiac disease. Imaging of stunning in Takotsubo cardiomyopathy is an example of how nuclear medicine techniques contribute to the understanding of cardiac disease.

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“…First step -Included clinical evaluation, continuous monitoring and 13-lead ECG tracings 11 , minute by minute, during 8 minutes, using the Teb Apex 2000 multi-channel recording system (TEB -São Paulo, Brazil), concomitantly with adenosine infused at 140 µg.kg.min -1 , over 6 minutes 12 , by intravenous pump (DigiBomb, model DB-03-FAJ, São Paulo, Brazil). A dose of 740 to 814 MegaBequerel (Mbq) of Tc-99m-MIBI was administered at the third minute of adenosine injection, and treadmill walking was added with energy expenditure up to seven metabolic equivalents (METs) after routine controls and IV aminophylline (1 to 2 mg.kg.min -1 ) in case side effects or high-risk ischemia signs persisted.…”

Section: Myocardial Perfusion Scintigraphy (Gated-spect)mentioning

confidence: 99%