Pharmacologic stress myocardial perfusion imaging

Rakesh N. Patel, Roque B. Arteaga, Mahendra K. Mandawat, John W. Thornton, Vincent J B Robinson

Research output: Contribution to journalReview article

12 Scopus citations

Abstract

Pharmacologic stress agents (dipyridamole, adenosine and dobutamine) allow virtually all patients to be safely assessed for ischemic heart disease. These agents have mild but significant side effects, mandating a thorough knowledge of indications, contraindications, side effects and management before their use. Adjunctive exercise improves image quality in vasodilator pharmacologic myocardial perfusion imaging. Diabetics, especially women, have a much higher cardiac event rate than nondiabetics for an equal amount of ischemia. They also have a higher incidence of asymptomatic ischemia. There is growing support for screening with myocardial perfusion imaging (MPI) for asymptomatic ischemia in diabetics. The ability of MPI to identify hypocontractile but viable myocardium, thus predicting improvement in myocardial function after revascularization, is one of the most powerful uses of the modality. Vasodilator MPI should be used as the initial test in patients with left bundle branch block or paced ventricular rhythm, even if they are able to exercise.

Original languageEnglish (US)
Pages (from-to)1006-1014
Number of pages9
JournalSouthern Medical Journal
Volume100
Issue number10
DOIs
StatePublished - Oct 1 2007

Keywords

  • Choice of stress tests
  • Coronary heart disease
  • Vasodilator stress testing

ASJC Scopus subject areas

  • Medicine(all)

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