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Ramón Castelló, MD; Ricardo Hidalgo, MD
Clínica Universitaria Facultad de Medicina Pamplona, Spain

JAMA. 1988;259(8):1179.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.

—In March 1987, an article entitled "Dipyridamole-Induced Myocardial Ischemia" was published in THE JOURNAL.¹ The authors described four patients awaiting urgent myocardial revascularization procedures in whom angina and ischemic electrocardiographic changes occurred after administration of oral dipyridamole. We were surprised to read the abstract because we considered it a common and well-known phenomenon. In their comment, however, the authors suggest that it must occur at other institutions, with an unknown prevalence.

In the last three years, we have hospitalized 453 patients for coronary artery bypass surgery. They all received 100 mg of oral dipyridamole four times a day for the two days before surgery. We observed exacerbation of angina and ischemic changes on electrocardiograms in 20 patients (4.4%). Anginal episodes always occurred at rest within 30 minutes of receiving the dipyridamole. In the majority of patients, symptoms and electrocardiographic changes resolved with sublingual nitroglycerin therapy. In . . . [Full Text PDF of this Article]

Footnotes
Edited by Drummond Rennie, MD, Senior Contributing Editor; Sharon Iverson, Assistant Editor.

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