What are the contraindications for pharmacologic vasodilatory and adrenergic agonist stress tests?
Pharmacologic vasodilatory stress tests are not performed in patients with severe reactive airway disease, particularly when a patient has active wheezing on physical examination. Patients who use inhalers but who otherwise have stable airway disease can often safely undergo these stress tests. Any patient taking dipyrimadole or methylxanthines does not undergo a vasodilatory stress test, unless the medication can be stopped for at least 24 to 48 hours. All patients who are to undergo vasodilatory studies should abstain from caffeine for 24 hours because caffeine blocks the effect of vasodilatory compounds and adenosine.
Adrenergic stress tests have similar contraindications to those of exercise testing except that musculoskeletal problems are not an issue. Furthermore, dobutamine can be used in patients with existing airway disease.