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Surviving a stressful MIBI scan

Published online by Cambridge University Press:  04 March 2015

Robert Gooch ,
Lisa Bryski  and
Ewa Courvoisier-Grzywacz
Robert Gooch*
Affiliation:
Department of Emergency Medicine, Emergency Medicine Residency Program, The University of Manitoba, Winnipeg, MB
Lisa Bryski
Affiliation:
Department of Emergency Medicine, The University of Manitoba, Winnipeg, MB
Ewa Courvoisier-Grzywacz
Affiliation:
Department of Emergency Medicine, The University of Manitoba, Winnipeg, MB
*
Department of Emergency Medicine, Room T258, Old Basic Sciences Bldg, 770 Bannatyne Avenue, Winnipeg, MB R3E 0W3; rgooch44@gmail.com.

Abstract

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Dipyridamole/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.

Keywords

aminophyllineasystoledipyridamoleMIBI
Type
Case Report • Rapport de cas
Information
Canadian Journal of Emergency Medicine , Volume 15 , Issue 6 , November 2013 , pp. 392 - 396
Copyright
Copyright © Canadian Association of Emergency Physicians 2013

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