Coronary Vasospasm While Treating Supraventricular Tachycardia: Is Adenosine Really to Blame?
Coronary artery spasm has been reported during adenosine stress testing. Herein, we describe a transient ST-segment elevation following adenosine therapy for supraventricular tachycardia. A 38-year-old male presented to the emergency department with palpitations. Electrocardiogram showed supraventri...
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| Language: | English |
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Wiley
2013-01-01
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| Series: | Case Reports in Cardiology |
| Online Access: | http://dx.doi.org/10.1155/2013/897813 |
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| author | Henry C. Quevedo Jerson Munoz-Mendoza Veronica Pinto Miranda Rafael F. Sequeira |
| author_facet | Henry C. Quevedo Jerson Munoz-Mendoza Veronica Pinto Miranda Rafael F. Sequeira |
| author_sort | Henry C. Quevedo |
| collection | DOAJ |
| description | Coronary artery spasm has been reported during adenosine stress testing. Herein, we describe a transient ST-segment elevation following adenosine therapy for supraventricular tachycardia. A 38-year-old male presented to the emergency department with palpitations. Electrocardiogram showed supraventricular tachycardia with short RP interval. Vagal maneuvers were unsuccessful. Adenosine was then administered in two successive injections of 6 and 12 mg dosages, respectively. A subsequent 12-lead electrocardiogram revealed ST-segment elevation in inferior leads with reciprocal changes. Coronary angiography disclosed nonobstructive coronary disease. A postprocedure electrocardiogram exhibited normal sinus rhythm with nonspecific T wave abnormalities. Cardiac biomarkers were elevated with a peak troponin I of 0.32. Echocardiogram depicted bicuspid aortic valve and normal systolic function. Electrophysiological study revealed a concealed left accessory pathway and successful radiofrequency ablation was performed. Given the dynamic changes in the electrocardiogram, we hypothesize that this event was most likely a coronary vasospasm. The mechanism of coronary spasm following adenosine injection remains uncertain. Potential mediators include channels and adenosine-2 receptors. |
| format | Article |
| id | doaj-art-5909f46f741c4f3db6abf95a79b01772 |
| institution | Kabale University |
| issn | 2090-6404 2090-6412 |
| language | English |
| publishDate | 2013-01-01 |
| publisher | Wiley |
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| series | Case Reports in Cardiology |
| spelling | doaj-art-5909f46f741c4f3db6abf95a79b017722025-08-20T03:34:40ZengWileyCase Reports in Cardiology2090-64042090-64122013-01-01201310.1155/2013/897813897813Coronary Vasospasm While Treating Supraventricular Tachycardia: Is Adenosine Really to Blame?Henry C. Quevedo0Jerson Munoz-Mendoza1Veronica Pinto Miranda2Rafael F. Sequeira3Tulane University, Heart and Vascular Institute, New Orleans, LA 70118, USAUniversity of Miami, Miller School of Medicine, Division of Internal Medicine, Miami, FL 33136, USAUniversity of Miami, Miller School of Medicine, Division of Internal Medicine, Miami, FL 33136, USAUniversity of Miami, Miller School of Medicine, Division of Cardiovascular Medicine, Miami, FL 33136, USACoronary artery spasm has been reported during adenosine stress testing. Herein, we describe a transient ST-segment elevation following adenosine therapy for supraventricular tachycardia. A 38-year-old male presented to the emergency department with palpitations. Electrocardiogram showed supraventricular tachycardia with short RP interval. Vagal maneuvers were unsuccessful. Adenosine was then administered in two successive injections of 6 and 12 mg dosages, respectively. A subsequent 12-lead electrocardiogram revealed ST-segment elevation in inferior leads with reciprocal changes. Coronary angiography disclosed nonobstructive coronary disease. A postprocedure electrocardiogram exhibited normal sinus rhythm with nonspecific T wave abnormalities. Cardiac biomarkers were elevated with a peak troponin I of 0.32. Echocardiogram depicted bicuspid aortic valve and normal systolic function. Electrophysiological study revealed a concealed left accessory pathway and successful radiofrequency ablation was performed. Given the dynamic changes in the electrocardiogram, we hypothesize that this event was most likely a coronary vasospasm. The mechanism of coronary spasm following adenosine injection remains uncertain. Potential mediators include channels and adenosine-2 receptors.http://dx.doi.org/10.1155/2013/897813 |
| spellingShingle | Henry C. Quevedo Jerson Munoz-Mendoza Veronica Pinto Miranda Rafael F. Sequeira Coronary Vasospasm While Treating Supraventricular Tachycardia: Is Adenosine Really to Blame? Case Reports in Cardiology |
| title | Coronary Vasospasm While Treating Supraventricular Tachycardia: Is Adenosine Really to Blame? |
| title_full | Coronary Vasospasm While Treating Supraventricular Tachycardia: Is Adenosine Really to Blame? |
| title_fullStr | Coronary Vasospasm While Treating Supraventricular Tachycardia: Is Adenosine Really to Blame? |
| title_full_unstemmed | Coronary Vasospasm While Treating Supraventricular Tachycardia: Is Adenosine Really to Blame? |
| title_short | Coronary Vasospasm While Treating Supraventricular Tachycardia: Is Adenosine Really to Blame? |
| title_sort | coronary vasospasm while treating supraventricular tachycardia is adenosine really to blame |
| url | http://dx.doi.org/10.1155/2013/897813 |
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