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Myocardial infarction after dipyridamole-assisted thallium-201 imaging

Journal Article · · DICP (Drug Interaction and Clinical Pharmacy ); (USA)
OSTI ID:5186011

A 77-year-old woman with suspected coronary artery disease underwent an oral dipyridamole/thallium-201 myocardial imaging study. Approximately 75 minutes after ingestion of dipyridamole 300 mg suspension, the patient developed chest pain, hypotension, nausea, and diaphoresis. An electrocardiogram revealed ST-T wave changes suggestive of inferior ischemia. Appropriate therapeutic measures, including aminophylline and nitroglycerin, were instituted. Delayed thallium images revealed reversible ischemia in the anteroseptal and posterobasal regions with a fixed defect in the inferobasal region. Cardiac enzyme studies were also indicative of acute myocardial injury. The patient subsequently underwent coronary arteriography and four-vessel coronary artery bypass grafting and was discharged without further complication. This report raises concerns about the potential danger of dipyridamole in patients with severe coronary artery stenosis and collateral circulation. Prophylactic aminophylline should be considered in these patients.

OSTI ID:
5186011
Journal Information:
DICP (Drug Interaction and Clinical Pharmacy ); (USA), Journal Name: DICP (Drug Interaction and Clinical Pharmacy ); (USA) Vol. 23:9; ISSN 1042-9611; ISSN DAPHE
Country of Publication:
United States
Language:
English