Severe Shivering as an Adverse Effect of Regadenoson Myocardial Perfusion Imaging

Abstract

Regadenoson myocardial perfusion imaging (MPI) is a widely used screening study for patients with an intermediate pretest probability of coronary artery disease (CAD). Via selective agonism of the adenosine A2A receptor, regadenoson can induce coronary steal, revealing stenotic vessel territory through transient ischemia. Common side effects of this medication include chest pain, shortness of breath, nausea, vomiting, atrioventricular block, seizure, and allergic reactions. Here we present a case of severe shivering and chest tightness after the administration of regadenoson, along with a physiologic explanation and treatment.

Myocardial Bridging of Mid-left Anterior Descending Artery (LAD) Presenting As Transient Left Bundle Branch Block During Nuclear Stress Test

“…Regadenoson, a selective A2a adenosine receptor agonist first approved by the FDA in April 2008, was used during our patient's NST to reveal underlying myocardial ischemia through vasodilation of the coronary arteries [13]. A2a receptors are stimulatory guanine nucleotide-binding proteins (G proteins) which, when bound to regadenoson, activate adenylyl cyclase, thereby increasing cyclic adenosine 5T monophosphate (cAMP).…”