title: Dobutamine-induced transmural myocardial ischemia in a patient with mild coronary lesions.
abstract: A 70-year-old man was admitted for evaluation of retrosternal pain at rest. During infusion of dobutamine (25 micrograms/kg/min) the patient developed angina, ST-segment elevation in the inferior leads, and echocardiographic hypokinesia in the inferior-basal myocardial wall. Coronary angiography revealed insignificant (20-30%) stenosis of the right coronary artery and a normal remaining tree. This case suggests that dobutamine may induce transmural myocardial ischemia in patients with mild coronary lesions, probably by producing occlusive coronary spasm on a substrate of arterial endothelial dysfunction.
authors.affiliation: First Department of Cardiology, Evangelismos Hospital, Athens, Greece.
authors.forename: F G
authors.initials: FG
authors.lastname: Kardaras
authors.forename: M S
authors.initials: MS
authors.lastname: Bonou
authors.forename: D F
authors.initials: DF
authors.lastname: Kardara
authors.forename: A I
authors.initials: AI
authors.lastname: Kranidis
authors.forename: E P
authors.initials: EP
authors.lastname: Sioras
authors.forename: L P
authors.initials: LP
authors.lastname: Anthopoulos
mesh_terms: D000318:Adrenergic beta-Agonists / Q000009:adverse effects*; D000368:Aged; D017023:Coronary Angiography; D003327:Coronary Disease / Q000175:diagnosis* / Q000000981:diagnostic imaging; D004280:Dobutamine / Q000009:adverse effects*; D004452:Echocardiography; D004562:Electrocardiography; D006801:Humans; D008297:Male; D017202:Myocardial Ischemia / Q000139:chemically induced* / Q000175:diagnosis
chemical_list: D000318:Adrenergic beta-Agonists; D004280:Dobutamine