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

## TL;DR

This paper reports a rare case where adenosine, typically used in cardiology, caused unexpected coronary spasms and highlights the importance of considering unusual side effects.

## Contribution

The first reported case linking adenosine to microvascular coronary spasms and identifying genetic variants associated with the condition.

## Key findings

- Adenosine was found to cause microvascular coronary spasms in a patient.
- Genetic testing revealed variants in the LMNA and PRKAG2 genes.
- The case showed transient prolonged QT and mild left ventricle dilation.

## Abstract

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.