CARDIAC STRESS TESTS-VASODILATORS

SUMMARY

1. Vasodilators work by dilating and increasing blood flow in normal cardiac vessels while doing little to change the flow in stenotic vessels.

2. The dilated normal vessels steal flow from the stenotic vessels, causing perfusion defects in scans (and ST segment changes in ECGs).

3. Vasodilators are not used in patients with history of bronchospasm.

4. Do not use adenosine or dipyridamole in someone with asthma or severe carotid stenosis.

5. Do not use dobutamine in someone with VT, uncontrolled HTN, or paced ventricular rhythm.

Reference(s)

Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].