Incidence of acute bronchospasm during systemic adenosine administration for coronary angiography

Background Adenosine is frequently used during coronary angiography to induce hyperaemia and allow operators to perform quantitative measurements of lesion severity. Acute bronchospasm is a recognised side effect relating to the activation of ‘off target’ A2B receptors. The true incidence of severe bronchospasm relating to adenosine administration is not known.

Levodopa-induced myocardial infarction in a patient with Parkinson’s disease and severe coronary artery disease

Levodopa is the most effective medical treatment for Parkinson’s disease (PD) to date. As dopamine is known to increase cardiac inotropism and vasomotor tone, peripheral dopamine decarboxylase inhibitor is coadministered to suppress the peripheral conversion of levodopa to dopamine. Levodopa poses potential cardiovascular risks, thus its use in patients with existing coronary artery disease needs to be carefully monitored. We report a case of an elderly male with newly diagnosed PD who developed non-ST-elevation myocardial infarction following levodopa (Madopar) initiation.

Radiation dose at CT coronary angiography: how low can we go?

Computed tomography (CT) coronary angiography is now a widely available and reliable test accessible on basic CT platforms that can exclude coronary heart disease with confidence. It is fast, cheap and, if properly carried out by trained and accredited staff in carefully selected patients, useful information can be obtained with acceptably low radiation exposure in some cases.