II. Definitions
- Myocardial Perfusion Imaging with Adenosine
- Pharmacologic Stress Testing in which Adenosine is used to stimulate increased cardiac workload
III. Approach
- Hold nitrates (Nitroglycerin) on day of the test
- Hold methylzanthines 24 hours before test
- Theodur
- Aminophylline
- Dipyridamole
IV. Preparations
V. Advantages
- Short duration of Adenosine action (<3 seconds)
- Vasodilator increases coronary flow 5x
- More sensitive than Dobutamine (but less specific)
- ST Depression specific for serious disease
- Left main Coronary Artery Disease
- Three-vessel Coronary Artery Disease
VI. Indications
- Left Bundle Branch Block
- Paced Rhythm
- WPW Syndrome
VII. Contraindications
- Hypotension with systolic Blood Pressure <90 mmHg
- Significant atrial Arrhythmia without a functioning Pacemaker
- Sinus node disease
- Mobitz 2 or Third Degree AV Block
- Active Wheezing in bronchospastic disease
- Moderate to Severe Asthma
- Severe Chronic Obstructive Pulmonary Disease (COPD)
- Concurrent medication use
- Dipyridamole
- Aggrenox
- Theophylline
- Caffeine prior to test (e.g. Coffee, Chocolate)
VIII. References
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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) |