Dipyridamole-atropine-induced myocardial infarction in a patient with patent epicardial coronary arteries

Background: The diagnostic accuracy of the physical and pharmacological str ess echocardiography tests is higher than routine exercise electrocardiogra phy. They have an acceptable safety profile and have been rarely associated with severe adverse effects. Case Report: We present a case of acute anterior myocardial reinfarction im mediately after exercise and pharmacological (dipyridamole-atropine) stress echocardiography testing 1 month after successful stent implantation in LA D. Our patient was a 43-year-old man with a history of heavy smoking and hy pertension. Remarkably, the stress echocardiogram was non-diagnostic few ho urs before the infarction occurred. Angiography performed 4 months after th e reinfarction revealed neither a culprit lesion nor stent thrombosis. Conclusion: Aggressive "last generation" pharmacological stress testing may provide optimal diagnostic accuracy, but as in our case, complications may occur, even after negative stress testing. To our knowledge, this is the f irst reported case of an acute myocardial infarction as a severe complicati on of stress testing, which developed in a patient after stent implantation .