Dipyridamole-induced ST-segment elevation indicative of transmural myocardial ischemia - A case report

Dipyridamole nuclear myocardial per-fusion test is a safe and effective alt ernative to exercise nuclear perfusion testing for detecting myocardial isc hemia. It is the procedure of choice in selected patients who are unable to exercise adequately. Intravenous dipyridamole causes coronary vasodilation with resultant maldistribution and heterogeneity of coronary flow in the p resence of significant coronary artery disease. True ischemia, causing symp toms or ST-segment depression, is uncommon, in part because there is no inc rease in myocardial oxygen demand. A patient in whom myocardial ischemia de veloped, manifested by ST-segment elevation, during dipyridamole stress tes ting is described, Scintigraphic images illustrated a myocardial perfusion defect, which was consistent with coronary angiographic findings. This case report addresses the importance of dipyridamole-induced ST-segment elevati on, its correlation with angiographic findings, and the need for continued hemodynamic and electrocardiographic monitoring in patients following dipyr idamole infusion.