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双嘧达莫诱发的ST段抬高型心肌梗死：病例报告及文献综述

Dipyridamole-induced STEMI: case report and review of the literature.

作者信息

Hennawi Hussam Al, Lakhani Sunita, Khan Shayan Iqbal, Atam Sarin, Sadiq Usama, Rigotti Joseph, Nair Abhinav

机构信息

Department of Internal Medicine, Jefferson Abington Hospital, Abington, PA, USA.

Department of Cardiology, Thomas Jefferson University Hospitals, Philadelphia, PA, USA.

出版信息

Glob Cardiol Sci Pract. 2023 Aug 1;2023(3):e202323. doi: 10.21542/gcsp.2023.23.

DOI:10.21542/gcsp.2023.23
PMID:37575290
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10422870/
Abstract

Dipyridamole nuclear myocardial perfusion imaging is a safe and useful modality for assessing myocardial ischemia. It is the modality of choice for cardiac risk stratification in patients who are unable to exercise. Intravenous dipyridamole causes coronary vasodilation and may result in heterogeneity of coronary blood flow in significant coronary artery disease. Ischemic electrocardiographic changes following pharmacological stress testing are less likely to occur compared with exercise stress tests. Ischemia is more likely to be present in the form of ST depression, with ST-segment elevation being exceedingly rare. We present the case of a 73-year-old patient who developed ST-segment elevation myocardial infarction following pharmacologic stress testing.

摘要

双嘧达莫核素心肌灌注显像对于评估心肌缺血是一种安全且有用的方法。对于无法进行运动的患者，它是心脏风险分层的首选方法。静脉注射双嘧达莫会导致冠状动脉扩张，在严重冠状动脉疾病中可能导致冠状动脉血流不均一性。与运动负荷试验相比，药物负荷试验后缺血性心电图改变不太可能发生。缺血更可能以ST段压低的形式出现，ST段抬高极为罕见。我们报告一例73岁患者在药物负荷试验后发生ST段抬高型心肌梗死的病例。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/85d2/10422870/31840685cf6c/gcsp-2023-3-e202323-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/85d2/10422870/35445b529179/gcsp-2023-3-e202323-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/85d2/10422870/25e9444bcd27/gcsp-2023-3-e202323-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/85d2/10422870/c90911d1cc82/gcsp-2023-3-e202323-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/85d2/10422870/31840685cf6c/gcsp-2023-3-e202323-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/85d2/10422870/35445b529179/gcsp-2023-3-e202323-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/85d2/10422870/25e9444bcd27/gcsp-2023-3-e202323-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/85d2/10422870/c90911d1cc82/gcsp-2023-3-e202323-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/85d2/10422870/31840685cf6c/gcsp-2023-3-e202323-g004.jpg

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本文引用的文献

1
A case report of dipyridamole stress-induced ST depression progressing to ST-elevation myocardial infarction despite intravenous aminophylline: steal, spasm, or something else?一例双嘧达莫负荷试验诱发ST段压低，尽管静脉注射氨茶碱仍进展为ST段抬高型心肌梗死的病例报告：窃血、痉挛，还是其他原因？
Eur Heart J Case Rep. 2019 Jun 1;3(2). doi: 10.1093/ehjcr/ytz054.
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ASNC imaging guidelines for SPECT nuclear cardiology procedures: Stress, protocols, and tracers.美国核医学与分子影像学会（ASNC）单光子发射计算机断层扫描（SPECT）核心脏病学检查的成像指南：负荷试验、方案及示踪剂
J Nucl Cardiol. 2016 Jun;23(3):606-39. doi: 10.1007/s12350-015-0387-x.
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Coronary steal and ST elevation during dipyridamole stress testing leading to coronary artery bypass grafting.
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[ST segment elevation during dipyridamole stress testing in a patient without coronary lesions].[无冠状动脉病变患者双嘧达莫负荷试验期间的ST段抬高]
Rev Esp Cardiol. 2004 Feb;57(2):177-9.
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Effects of Persantin (RA8), a new coronary vasodilator, on coronary blood flow and cardiac dynamics in the dog.新型冠状动脉扩张剂潘生丁（RA8）对犬冠状动脉血流量和心脏动力学的影响。
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The relationship between coronary blood flow, myocardial oxygen consumption and cardiac work as influenced by persantin.潘生丁对冠状动脉血流量、心肌耗氧量及心脏作功之间关系的影响
Am J Cardiol. 1962 Mar;9:449-54. doi: 10.1016/0002-9149(62)90162-5.
7
[Stress echocardiography in the pre-operative evaluation of patients undergoing major vascular surgery. Are results comparable with dypiridamole versus dobutamine stress echo?].[大血管手术患者术前评估中的负荷超声心动图。双嘧达莫与多巴酚丁胺负荷超声心动图的结果是否具有可比性？]
Rev Esp Cardiol. 2002 Feb;55(2):121-6. doi: 10.1016/s0300-8932(02)76571-8.
8
Dipyridamole-induced ST-segment elevation indicative of transmural myocardial ischemia--a case report.双嘧达莫诱发的ST段抬高提示透壁性心肌缺血——病例报告
Angiology. 2001 Aug;52(8):553-7. doi: 10.1177/000331970105200808.
9
Severe transmural myocardial ischemia after dipyridamole administration implicating coronary steal.双嘧达莫给药后出现严重透壁性心肌缺血，提示冠状动脉窃血。
Clin Cardiol. 1998 Apr;21(4):293-6. doi: 10.1002/clc.4960210413.
10
Safety of dipyridamole testing in 73,806 patients: the Multicenter Dipyridamole Safety Study.73806例患者双嘧达莫试验的安全性：多中心双嘧达莫安全性研究
J Nucl Cardiol. 1995 Jan-Feb;2(1):3-17. doi: 10.1016/s1071-3581(05)80003-0.