II. Definitions

  1. Myocardial Perfusion Imaging with Adenosine
    1. Pharmacologic Stress Testing in which Adenosine is used to stimulate increased cardiac workload

III. Approach

  1. Hold nitrates (Nitroglycerin) on day of the test
  2. Hold methylzanthines 24 hours before test
    1. Theodur
    2. Aminophylline
    3. Dipyridamole

IV. Preparations

  1. Adenosine or
  2. Regadenoson (Lexiscan)
    1. Longer half life than Adenosine
    2. Can be adminstered as bolus instead of continuous infusion

V. Advantages

  1. Short duration of Adenosine action (<3 seconds)
  2. Vasodilator increases coronary flow 5x
  3. More sensitive than Dobutamine (but less specific)
  4. ST Depression specific for serious disease
    1. Left main Coronary Artery Disease
    2. Three-vessel Coronary Artery Disease

VI. Indications

VII. Contraindications

  1. Hypotension with systolic Blood Pressure <90 mmHg
  2. Significant atrial Arrhythmia without a functioning Pacemaker
    1. Sinus node disease
    2. Mobitz 2 or Third Degree AV Block
  3. Active Wheezing in bronchospastic disease
    1. Moderate to Severe Asthma
    2. Severe Chronic Obstructive Pulmonary Disease (COPD)
  4. Concurrent medication use
    1. Dipyridamole
    2. Aggrenox
    3. Theophylline
    4. Caffeine prior to test (e.g. Coffee, Chocolate)

Images: Related links to external sites (from Bing)

Related Studies

Ontology: Cardiovascular stress test using the adenosine stress test protocol (C1827363)

Concepts Diagnostic Procedure (T060)
SnomedCT 424444005
English Cardiovascular stress test using the adenosine stress test protocol (procedure), Cardiovascular stress test using the adenosine stress test protocol
Spanish prueba de estrés cardiovascular con utilización de protocolo con adenosina, prueba de estrés cardiovascular con utilización de protocolo con adenosina (procedimiento)