Coronary spasm after an adenosine stress test: an adverse effect of a vasodilator.

The occurrence of a coronary spasm after an adenosine stress test is an exceptional event. We report a vasospasm in a patient with normal coronary angiography. The spasm occurred shortly after termination of adenosine infusion on abrupt withdrawal of vasodilation. Ischaemia induced ventricular arrhythmia (bursts of polymorphous tachycardia) that responded well to antispastic therapy. The main identified predisposing factor for coronary spasm was vasospastic angina and adenosine acted as a revealing factor of this unsuspected diagnosis.