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CASE REPORT
Year : 2016  |  Volume : 26  |  Issue : 4  |  Page : 120-122

The diagnostic challenge of dipyridamole-atropine stress echocardiography in a patient with myocardial bridge


Department of Clinical-Experimental Medicine and Pharmacology, Cardiology Division, University of Messina, Messina, Italy

Correspondence Address:
Maurizio Cusmą Piccione
Department of Clinical-Experimental Medicine and Pharmacology, Cardiology Division, University of Messina, Via Consolare Valeria, Messina 98100
Italy
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2211-4122.192175

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A 60-year-old male patient was submitted to dipyridamole-atropine stress echocardiography (DSE) for chest pain during exertion. At rest, no electrocardiographic (ECG) and transthoracic echocardiographic (TTE) abnormalities were observed. After dipyridamole infusion, the patient complained a mild chest discomfort, without ECG changes and TTE wall-motion abnormalities. Subsequently, worsening of the anginal symptoms combined with descending ST-depression and T-negative waves occurred after atropine and unexpectedly, aminophylline administration. Coronary angiography was performed showing a myocardial bridge (MB) of the left anterior descending artery. The occurrence, during DSE, of worsening ischemic abnormalities after atropine and aminophylline administration may be a particular diagnostic feature of MB.


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