Complications after dipyridamole infusion in myocardial perfusion SPECT and correlation with homodynamic changes

ABSTRACT

In Iran dipyridamole is the main agent used for coronary dilatation before myocardial perfusion SPECT. This study tries to evaluate the side effects after dipyridamole infusion and its relation with hemodynamic changes. We studied 300 patients who referred to myocardial perfusion scan. The exclusion criteria were 1] AV block degree 2 or more, 2] Asthma 3] Sick sinus syndrome 4] LV EF<25%. Dipyridamole infusion was done with a dose of 0.568 mg/kg of body weight for 4 minutes and blood pressure and pulse rate were measured before infusion of dipyridamole and 2 minutes after termination of infusion. Patients were asked for any side effects and any complaints were recorded. Relationship between these side effects and age and sex of patients as well as hemodynamic changes were studied. 148 female and 152 male patients studied with a mean age of 55.9 years [11.1]. After dipyridamole infusion 79.3% of patients had at least one symptom, with headache [50%] and sweating [3%], the most and the least prevalent symptoms respectively. Mean heart rate increment was 8.8 and 9.2 beat per minute in female and male respectively [P=0.59]. Mean systolic blood pressure decrement was 8.5 [8.6] and 9.6 [7.1] mmHg in male and female respectively [P=0.21]. Diastolic pressure decrement was 4.6 [6.7] and 6.8 [6.3] mmHg in male and female respectively [P=0.003]. Headache and flashing were more frequent in female patients [P=0.004]. Other symptoms like dizziness, dyspnea, chest discomfort and abdominal discomfort were not different between female and male patients [P>0.08]. After dipyridamole infusion, nonspecific side effects are frequent. Headache and flashing is more frequent in female patients. Flashing is related to decrement in diastolic blood pressure