Coronary Vasospasm, an Unexpected Side Effect of Adenosine: A Case Report and Review of the Literature.

Adenosine is a well-known product in the field of cardiology, known to cause coronary vasodilation. However, in rare cases, it has been associated with coronary vasoconstriction. In this case-the first to our knowledge-we have demonstrated that adenosine could be the cause of microvascular coronary spasms, based on the symptoms, ECG, and coronary functional assessments. Additionally, we have linked this case with a transient prolonged QT and mild dilated left ventricle, which was further investigated with a loop recorder and genetic testing revealing variants in the LMNA gene and PRKAG2 gene. This case also emphasizes that physicians should always take into account unexpected side effects during standard procedures.