scholarly journals Seizure: An Adverse Effect of Regadenoson in Myocardial Perfusion Imaging

2019 ◽  
Vol 2019 ◽  
pp. 1-3 ◽  
Author(s):  
Sohab S. Radwan ◽  
Owen G. Schwartz
Keyword(s):  
Adverse Effect ◽  
Stress Testing ◽  
Seizure Threshold ◽  
Severe Adverse Effect ◽  
Cardiac Stress ◽  
A2a Receptor ◽  
Patients At Risk ◽  
The Central Nervous System ◽  
Artery Disease ◽  
Modern Era

Regadenoson is a selective adenosine 2a (A2a) receptor agonist that is used in cardiac stress testing to evaluate for ischemic heart disease and has largely replaced adenosine in the modern era. Since adenosine receptors are involved in synaptic transmission between neurons throughout the central nervous system (CNS) including the cerebral cortex, hippocampus, and other structures as well, regadenoson can lower the seizure threshold in susceptible individuals. Epileptogenic activity is an uncommon yet potentially severe adverse effect of regadenoson use, and therefore, more awareness is required in screening patients at risk and evaluating alternate ways to investigate coronary artery disease (CAD) in susceptible individuals.

scholarly journals Surviving a stressful MIBI scan

CJEM ◽  
2013 ◽  
Vol 15 (06) ◽  
pp. 392-396 ◽  
Author(s):  
Robert Gooch ◽  
Lisa Bryski ◽  
Ewa Courvoisier-Grzywacz
Keyword(s):  
Coronary Artery Disease ◽  
Stress Testing ◽  
Stress Test ◽  
Pharmacologic Stress ◽  
Test Laboratory ◽  
Cardiac Monitoring ◽  
Emergency Physicians ◽  
Hemodynamic Stability ◽  
Cardiac Stress ◽  
Artery Disease

ABSTRACTDipyridamole/technetium sestamibi scans (more commonly known as MIBI scans, an acronym for methoxyisobutyl isonitrile) are used commonly for the diagnosis and risk stratification of coronary artery disease. Adverse events from MIBI scans are extremely rare. We present the case of a 64-year-old man who was successfully resuscitated after two asystolic episodes following dipyridamole infusion for a MIBI scan. The second asystolic episode occurred in the emergency department 40 minutes after the patient had been transferred from the Cardiac Stress Test Laboratory. To our knowledge, there are no previous reports of patients having two discrete asystolic episodes or an asystolic episode as delayed as we report after a MIBI scan. Our case illustrates why emergency physicians should be aware of the potential for asystole following MIBI scanning and why aminophylline, the antidote for dipyridamole, should be readily available in emergency departments that could see patients after pharmacologic stress testing. Patients who become asystolic following dipyridamole infusion likely require prolonged cardiac monitoring, given the potential for further episodes after periods of hemodynamic stability.

Coronary Artery Findings After Left-Sided Compared With Right-Sided Radiation Treatment for Early-Stage Breast Cancer

2007 ◽  
Vol 25 (21) ◽  
pp. 3031-3037 ◽  
Author(s):  
Candace R. Correa ◽  
Harold I. Litt ◽  
Wei-Ting Hwang ◽  
Victor A. Ferrari ◽  
Lawrence J. Solin ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Coronary Artery ◽  
Stress Testing ◽  
Radiation Treatment ◽  
Early Stage ◽  
Breast Conservation ◽  
Cardiac Stress ◽  
Coronary Stenoses ◽  
Cardiac Stress Testing ◽  
Artery Disease

PurposeTo compare the incidence and distribution of coronary artery disease after left-sided versus right-sided irradiation in patients treated with breast conservation for early-stage breast cancer who subsequently underwent cardiac stress testing and/or catheterization for cardiovascular symptoms.Patients and MethodsThe medical records of 961 stage I-II breast cancer patients treated from 1977 to 1995 at the University of Pennsylvania with conventional tangential beam radiation treatment (RT) were screened for cardiac stress tests and catheterizations performed after RT. The results of these tests were analyzed by laterality of RT and compared with baseline cardiovascular risk.ResultsAt diagnosis, patients with left-sided and right-sided breast cancer had the same estimated 10-year risk (both 7%) of developing coronary artery disease. At a median time of 12 years post-RT (range, 2 to 24 years), 46 patients with left-sided and 36 patients with right-sided breast cancer (total, N = 82) had undergone cardiac stress testing. A statistically significant higher prevalence of stress test abnormalities was found among left (27 of 46; 59%) versus right-side irradiated patients (three of 36; 8%; P = .001). Furthermore, 19 of 27 of left-sided abnormalities (70%) were in the left anterior descending artery territory. Thirteen left-side irradiated patients also underwent cardiac catheterization revealing 12 of 13 with coronary stenoses (92%) and eight of 13 with coronary stenoses (62%) solely in the left anterior descending artery.ConclusionPatients treated with left-sided radiation as a component of breast conservation have an increased risk of late, radiation-associated coronary damage. Treatment with modern radiation techniques may reduce the risk of cardiac injury.

scholarly journals Relation of abnormal cardiac stress testing with outcomes in patients undergoing renal transplantation

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0260718
Author(s):  
Kelsey Anderson ◽  
Chirag Bavishi ◽  
Dhaval Kolte ◽  
Reginald Gohh ◽  
James A. Arrighi ◽  
...  
Keyword(s):  
Renal Transplantation ◽  
Renal Transplant ◽  
Stress Testing ◽  
Stress Test ◽  
Major Adverse Cardiovascular Events ◽  
Cardiac Stress ◽  
Cardiac Stress Testing ◽  
Artery Disease ◽  
Test Result

Cardiovascular risk stratification is often performed in patients considered for renal transplantation. In a single center, we sought to examine the association between abnormal stress testing with imaging and post-renal transplant major adverse cardiovascular events (MACE) using multivariable logistic regression. From January 2006 to May 2016 232 patients underwent renal transplantation and 59 (25%) had an abnormal stress test result. Compared to patients with a normal stress test, patients with an abnormal stress test had a higher prevalence of dyslipidemia, diabetes mellitus, obesity, coronary artery disease (CAD), and heart failure. Among those with an abnormal result, 45 (76%) had mild, 10 (17%) moderate, and 4 (7%) severe ischemia. In our cohort, 9 patients (3.9%) had MACE at 30-days post-transplant, 5 of whom had an abnormal stress test. The long-term MACE rate, at a median of 5 years, was 32%. After adjustment, diabetes (OR 2.37, 95% CI 1.12–5.00, p = 0.02), CAD (OR: 3.05, 95% CI 1.30–7.14, p = 0.01) and atrial fibrillation (OR: 5.86, 95% CI 1.86–18.44, p = 0.002) were independently associated with long-term MACE, but an abnormal stress test was not (OR: 0.83, 95% CI 0.37–1.92, p = 0.68). In conclusion, cardiac stress testing was not an independent predictor of long-term MACE among patients undergoing renal transplant.

scholarly journals Risk Factors of Daptomycin-Induced Eosinophilic Pneumonia in a Population with Osteoarticular Infection

Antibiotics ◽  
2021 ◽  
Vol 10 (4) ◽  
pp. 446
Author(s):  
Laura Soldevila-Boixader ◽  
Bernat Villanueva ◽  
Marta Ulldemolins ◽  
Eva Benavent ◽  
Ariadna Padulles ◽  
...  
Keyword(s):  
Risk Factors ◽  
Adverse Effect ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Older Patients ◽  
Retrospective Cohort ◽  
Joint Infection ◽  
Eosinophilic Pneumonia ◽  
Severe Adverse Effect ◽  
Osteoarticular Infection

Background: Daptomycin-induced eosinophilic pneumonia (DEP) is a rare but severe adverse effect and the risk factors are unknown. The aim of this study was to determine risk factors for DEP. Methods: A retrospective cohort study was performed at the Bone and Joint Infection Unit of the Hospital Universitari Bellvitge (January 2014–December 2018). To identify risk factors for DEP, cases were divided into two groups: those who developed DEP and those without DEP. Results: Among the whole cohort (n = 229) we identified 11 DEP cases (4.8%) and this percentage almost doubled in the subgroup of patients ≥70 years (8.1%). The risk factors for DEP were age ≥70 years (HR 10.19, 95%CI 1.28–80.93), therapy >14 days (7.71, 1.98–30.09) and total cumulative dose of daptomycin ≥10 g (5.30, 1.14–24.66). Conclusions: Clinicians should monitor cumulative daptomycin dosage to minimize DEP risk, and be cautious particularly in older patients when the total dose of daptomycin exceeds 10 g.

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