Dipyridamole-echocardiography test: historical background and physiologic basis

Dipyridamole was first introduced as an antianginal, coronary vasodilator agent. It was soon found that this drug could not prevent effort ischaemia; on the contrary, given intravenously, it could frequently induce ischaemia in the presence of coronary artery stenosis. This property was exploited for the diagnosis of coronary artery disease. The dipyridamole–induced ischaemia was detected by different techniques: ST–segment depression, thallium 201 scintigraphy and echocardiography. This review article describes the mechanisms underlying dipyridamole–induced ischaemia and discusses the value of this pharmacologic stress test for the detection of coronary artery disease.‘Life must be lived going ahead, but it can be understood only coming back’ (Soren Kierkegaard).