Safety of ergot stress echocardiography for non-invasive detection of coronary vasospasm

A. Pálinkás, Eugenio Picano, Olaf Rodriguez, Ana Diordjevic-Dikic, Patrizia Landi, A. Varga, Bruno Ghelarducci

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Background: The safety of ergonovine/ergometrine stress testing for coronary vasospasm when performed outside the cardiac catheterization laboratory (cath lab) has been questioned vigorously. Aim: To assess the tolerability and safety of ergonovine/ergometrine stress testing performed in the echocardiographic laboratory (echo lab). Methods: We retrospectively reviewed the data prospectively collected in the echo lab of the Institute of Clinical Physiology from 1 January 1985 to 1 June 2000, from 587 tests performed on 573 patients (either ergonovine or ergometrine stress echocardiography testing). By selection, all patients had a history of chest pain, consistent with vasospastic angina, negative exercise stress testing or stress echocardiography (with dipyridamole, dobutamine or exercise), and normal or near normal resting left ventricular function. Ergonovine or ergometrine maleate was injected up to a total cumulative dosage of 0.35 mg, under continuous 12-lead electrocardiographic and two-dimensional echocardiographic monitoring. Results: There were no deaths, myocardial infarctions, ventricular fibrillations or third degree AV blocks. One patient had non-sustained ventricular tachycardia associated with transient ST segment elevation 30 min after the test. Three patients had second degree AV block associated with a positive echocardiography test that was promptly reversed by nitrates administration. Transient regional myocardial dysfunction occurred in 79 patients (13%). Limiting ischaemia-independent side effects were present in 17 patients (3%): hypotension in one, arterial hypertension in five, non-sustained ventricular tachycardia in two and nausea or vomiting in ten. The test was well tolerated and echocardiograms were interpretable in 97% of the tests performed. Conclusion: Pharmacological stress echocardiography with either ergonovine or ergometrine is well tolerated and can be performed with relatively low risk in the echo lab in properly selected patients in whom coronary vasospasm is suspected.

Original languageEnglish
Pages (from-to)649-654
Number of pages6
JournalCoronary Artery Disease
Volume12
Issue number8
DOIs
Publication statusPublished - 2001

Fingerprint

Coronary Vasospasm
Ergonovine
Stress Echocardiography
Safety
Atrioventricular Block
Ventricular Tachycardia
Exercise
Dobutamine
Dipyridamole
Ventricular Fibrillation
Cardiac Catheterization
Chest Pain
Left Ventricular Function
Nitrates
Hypotension
Nausea
Vomiting
Echocardiography
Ischemia
Myocardial Infarction

Keywords

  • Echocardiography
  • Ergornetrine
  • Stress
  • Vasospasm

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Safety of ergot stress echocardiography for non-invasive detection of coronary vasospasm. / Pálinkás, A.; Picano, Eugenio; Rodriguez, Olaf; Diordjevic-Dikic, Ana; Landi, Patrizia; Varga, A.; Ghelarducci, Bruno.

In: Coronary Artery Disease, Vol. 12, No. 8, 2001, p. 649-654.

Research output: Contribution to journalArticle

Pálinkás, A. ; Picano, Eugenio ; Rodriguez, Olaf ; Diordjevic-Dikic, Ana ; Landi, Patrizia ; Varga, A. ; Ghelarducci, Bruno. / Safety of ergot stress echocardiography for non-invasive detection of coronary vasospasm. In: Coronary Artery Disease. 2001 ; Vol. 12, No. 8. pp. 649-654.
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T1 - Safety of ergot stress echocardiography for non-invasive detection of coronary vasospasm

AU - Pálinkás, A.

AU - Picano, Eugenio

AU - Rodriguez, Olaf

AU - Diordjevic-Dikic, Ana

AU - Landi, Patrizia

AU - Varga, A.

AU - Ghelarducci, Bruno

PY - 2001

Y1 - 2001

N2 - Background: The safety of ergonovine/ergometrine stress testing for coronary vasospasm when performed outside the cardiac catheterization laboratory (cath lab) has been questioned vigorously. Aim: To assess the tolerability and safety of ergonovine/ergometrine stress testing performed in the echocardiographic laboratory (echo lab). Methods: We retrospectively reviewed the data prospectively collected in the echo lab of the Institute of Clinical Physiology from 1 January 1985 to 1 June 2000, from 587 tests performed on 573 patients (either ergonovine or ergometrine stress echocardiography testing). By selection, all patients had a history of chest pain, consistent with vasospastic angina, negative exercise stress testing or stress echocardiography (with dipyridamole, dobutamine or exercise), and normal or near normal resting left ventricular function. Ergonovine or ergometrine maleate was injected up to a total cumulative dosage of 0.35 mg, under continuous 12-lead electrocardiographic and two-dimensional echocardiographic monitoring. Results: There were no deaths, myocardial infarctions, ventricular fibrillations or third degree AV blocks. One patient had non-sustained ventricular tachycardia associated with transient ST segment elevation 30 min after the test. Three patients had second degree AV block associated with a positive echocardiography test that was promptly reversed by nitrates administration. Transient regional myocardial dysfunction occurred in 79 patients (13%). Limiting ischaemia-independent side effects were present in 17 patients (3%): hypotension in one, arterial hypertension in five, non-sustained ventricular tachycardia in two and nausea or vomiting in ten. The test was well tolerated and echocardiograms were interpretable in 97% of the tests performed. Conclusion: Pharmacological stress echocardiography with either ergonovine or ergometrine is well tolerated and can be performed with relatively low risk in the echo lab in properly selected patients in whom coronary vasospasm is suspected.

AB - Background: The safety of ergonovine/ergometrine stress testing for coronary vasospasm when performed outside the cardiac catheterization laboratory (cath lab) has been questioned vigorously. Aim: To assess the tolerability and safety of ergonovine/ergometrine stress testing performed in the echocardiographic laboratory (echo lab). Methods: We retrospectively reviewed the data prospectively collected in the echo lab of the Institute of Clinical Physiology from 1 January 1985 to 1 June 2000, from 587 tests performed on 573 patients (either ergonovine or ergometrine stress echocardiography testing). By selection, all patients had a history of chest pain, consistent with vasospastic angina, negative exercise stress testing or stress echocardiography (with dipyridamole, dobutamine or exercise), and normal or near normal resting left ventricular function. Ergonovine or ergometrine maleate was injected up to a total cumulative dosage of 0.35 mg, under continuous 12-lead electrocardiographic and two-dimensional echocardiographic monitoring. Results: There were no deaths, myocardial infarctions, ventricular fibrillations or third degree AV blocks. One patient had non-sustained ventricular tachycardia associated with transient ST segment elevation 30 min after the test. Three patients had second degree AV block associated with a positive echocardiography test that was promptly reversed by nitrates administration. Transient regional myocardial dysfunction occurred in 79 patients (13%). Limiting ischaemia-independent side effects were present in 17 patients (3%): hypotension in one, arterial hypertension in five, non-sustained ventricular tachycardia in two and nausea or vomiting in ten. The test was well tolerated and echocardiograms were interpretable in 97% of the tests performed. Conclusion: Pharmacological stress echocardiography with either ergonovine or ergometrine is well tolerated and can be performed with relatively low risk in the echo lab in properly selected patients in whom coronary vasospasm is suspected.

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KW - Ergornetrine

KW - Stress

KW - Vasospasm

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